Jen Reed-Hunter wrote:
>
> I have been working on getting a pump for myself through my insurance. . . . .  So I thought about it, ask the pedi for a rx for a pump...she had no problem with helping me get one...but unless the
> baby is in the hospital...the insurance will not pay for one.

It is not unusual for insurance companies to refuse to pay for items
which are not actually associated with the treatment of an illness.  And
that is probably not going to change for quite awhile.  There is a big
economic issue here.

You said "I am trying to return back to work."  That may be the key to
getting what you need.  Where is your insurance coming from?  Are you
insured under an employer's group health policy?  Is it your employer or
your husband's?  If this insurance which you have purchased yourself you
are in a highly unusual situation. If that is the case then go to battle
with the insurer, but if it isn't you will probably be wasting your
energy.

You ask, "How can I promote breastfeeding and try to help others with
insurance companies being such a pain in the rear?"  Why should the
insurance company provide a breast pump to a nursing mother with a
healthy infant?

Most insurance is purchased by the employer, or is actually
self-insurance up to a certain dollar value with "re-insurance" for
higher costs.  The "insurance" company simple processes claims and
applies certain screening protocols to determine the appropriateness of
payment.  In those cases the insurance company is not very responsive to
the consumer, but is more responsive to the employer, who pays the
costs.  When the costs come out of the employer's pocket then the
employer becomes more responsive to practices which might decrease
costs.

Writing an irrate letter to the insurance company will probably
accomplish little.  But do tell your story to your employer.  Cite the
benefits of continued breastmilk intake by your infant and request
assistance in continuing your breastfeeding.  Explain that an electric
hospital grade pump will make the difference in your ability to do
this.  Maybe even have that helpful pedi write a letter extolling the
particular benefits your infant would receive.  If the insurance is
provided by either employer, there is a financial incentive for the
employer to assist you in obtaining the breast pump because the health
care costs for a non-breastfed infant are higher.  Cite figures which
demonstrate this.  They are available at a number of websites.

Take along a copy of the article by Minnesota State Senator Ellen
Anderson, which is available at
http://www.nursingmother.com/advocacy/advocacy_my_bill.html


Now this how we can really influence attitudes and practices.  This is
what Kathy D is talking about.  When women run up against cultural
obstructions they need to find creative means of bringing them down.
Advocacy on our own behalf is worth the effort many times.  It also
gives us the experience to help others advocate for their own particular
needs also.  "Self-efficacy" is the most empowering belief we can have.

Melinda Hoskins, MS, RN

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