Frequently Asked Questions: Insurance Covered Breast Pumps
If you're like many of the moms we help, it's your first time getting a breast pump through insurance. So, naturally, many of the details will be new to you - the process, your coverage, required documents, etc.
Our knowledgeable team pulled together the questions they are asked most often and answers that are sure to help. Have a question not covered here? Email us at email@example.com or call us at (888) 977-2229.
How to get a breast pump through insurance?
- Complete our intake form so that we can verify your insurance coverage. It takes less than 3 minutes to complete and we will verify your coverage.
- Choose your breast pump model. We offer top brands, Lansinoh, Medela, and Spectra. We'll let you know which models are fully covered and which may require out-of-pocket expense.
- We will work with you and your doctor to obtain a prescription for your breast pump. Once we receive your prescription, your order will ship!
(Delays in shipment may result from insurance requirements or product availability.)
What are the advantages of ordering my breast pump through 1 Natural Way?
We offer the easiest process in the industry backed by thousands of reviews and testimonials from moms everywhere.
- We complete a verification
- We offer the top brands in the industry such as Elvie, Lansinoh, Medela, and Spectra
- We work to obtain a prescription on your behalf
- We offer FREE standard ground shipping on breast pump purchases.
- We file your claim with the insurance
When can I order my breast pump?
You can place your order at any time!
Do I need a Prescription?
Yes! 1 Natural Way requires a prescription before we can ship your breast pump. We will work with you and your doctor to obtain a prescription for your breast pump.
Most doctors will not sign a breast pump prescription without speaking to you. We recommend that you contact your doctor and request that they send a prescription to us via fax at (877) 722-5010 or let them know we will be sending a request on your behalf. Also, all prescriptions must have a diagnosis code on it. Most insurances cover the diagnosis code Z39.1 for a breast pump.
Why do I need a prescription?
Most insurance companies require a prescription for a breast pump for medical necessity.
1 Natural Way recommends contacting your doctor's office to let them know that you have placed an order for a breast pump and that you require a prescription before shipment.
What if I don't want to use insurance to purchase my breast pump?
That's ok too! You are able to purchase at the retail price.
Can I get two different pumps?
Not usually. Most insurance companies only cover one, but you are welcome to purchase a second out-of-pocket at retail cost.
When will I receive my breast pump?
After we obtain your prescription, your order will ship. 1 Natural Way ships all orders with FREE standard ground shipping which takes approximately 5-7 business days. You will receive a tracking number via email within 24 hours of your order leaving our warehouse.
How can I check the status of my order?
You can log in to your account at 1naturalway.com using your user name and password to check your order status at any time. If you have any issues please reach out to us by sending an email to firstname.lastname@example.org or give us a call at (888) 977-2229. 1 Natural Way responds to all inquiries during business hours. Usually within 24 business hours.
What does my order status mean?
|Status||Meaning||Do I (Mom) need to do anything?||What should I (Mom) do?|
|Order Created||An order has been created on your account.||No|
|Pending Payment Confirmation||Waiting for confirmation that payment has been received.||Maybe||If you have an unpaid order or invoice, that will need paying. Otherwise, your order is being processed.|
|Need to Sign Attestation Form||We sent you a form that needs to be electronically signed.||Yes||Check your email or sign in to your account to sign the Attestation Form.|
|Pending Insurance Verification||We are waiting to see what your insurance provider says.||No||Nothing! Unless we don't have your correct insurance information. Reach out with the correct info ASAP and we can get you on track.|
|Sent for Insurance Verification||We are waiting to see what your insurance provider says.||No||Nothing! Unless we don't have your correct insurance information. Reach out with the correct info ASAP and we can get you on track.|
|Pending Prescription||We still require a prescription from you.||Maybe||Sometimes it is helpful to follow up with your doctor.|
|Need to Send Invoice||1NW will be sending you an invoice for an out-of-pocket cost.||No||Keep an eye out for an email.|
|Need to Pay Invoice||There is an unpaid invoice waiting.||Yes||After payment is received we can move things onto the next step.|
|On Hold||Your order is being held for a specific reason.||Probably not||Examples include holding until a certain week of your pregnancy per your insurance or pre-ordering a new model that is not yet in stock.|
|Pending Release||Your order is on file.||No||Just hold tight! We will send you any updates in status promptly.|
|Pending Fulfillment||Your order is about to leave our warehouse. You will receive shipping information via email when it does.||No||Nothing! Your order will be on the way soon.|
|Fulfilled||Your order is on the way or has already been delivered. You will be able to track it within 24 hours of it leaving our warehouse.||No||Check your tracking email for details!|
|Canceled||Your order has been canceled.||No|
|Deleted||Part or all of your order has been deleted.||No|
When will I get tracking information for my package?
We send you shipping confirmation with tracking when your package ships. Please allow up to 24 hours for the carrier to update your tracking.
When will my claim be submitted to the insurance company?
Claims are submitted to the insurance company after the product has shipped. The shipment date is the date that is submitted to your insurance company to indicate when the service was provided. This is known as the date of service.
What does the "date of service" mean?
The date of service is the specific date at which a patient was provided medical services. For 1 Natural Way this means the date your order is shipped.
What is the difference between a standard breast pump and an upgraded breast pump?
A standard breast pump provides the basic features medically necessary to express breast milk. An upgraded breast pump provides additional features in addition to the standard breast pump which are primarily for comfort and convenience.
What is an upgrade fee?
We offer upgraded options as a courtesy to provide more options for moms who want to pay a little extra for the comfort and convenience of those extra features. This upgrade fee is in addition to the standard breast pump charge submitted to your insurance.
Is the upgrade fee reimbursable by my insurance?
Most insurance plans will cover a standard breast pump however insurance plans vary therefore we would suggest that you contact your insurance company.
What is the difference between the upgrade fee that I paid and purchasing the breast pump at retail?
An upgrade fee is collected in addition to the amount that we are expecting your insurance to cover for a standard breast pump. When you purchase a breast at retail from us, you are paying the full retail price of the breast pump and you may submit your receipt to your insurance for reimbursement if you choose to do so. We would not submit the claim to your insurance on your behalf.
Why is there a difference in allowable rate from my friend/coworker who also just received the same breast pump?
Your insurance has a predetermined allowable rate for a standard breast pump. This rate could vary by DME providers due to various contracted amounts, therefore the allowable amount could be different from another provider.
What if I don't like the pump I chose after using it?
Our return policy is very specific and returned items must be new, unopened, unused, and in their original packaging with the manufacturer's factory seal is still intact. While we cannot return a used, or opened, pump we are able to help you make another choice if you choose to purchase a second pump at retail.
What if my breast pump is defective?
You will need to contact the manufacturer's customer service directly. Their customer service department will work with you to troubleshoot any issues you are having with your pump or any parts that are deemed defective.
- Ameda: (866) 992-6332
- Ardo: (415) 504-1754
- Elvie: (929) 239-3212
- Freemie: (916) 339-7388
- Lansinoh: (800) 292-4794
- Medela: (800) 435-8316
- Motif: (844) 272-8390
- Spectra: (855) 446-6622
- Willow: (888) 945-5693
What is a breast pump flange/shield?
The breast pump part that comes in contact with your body, and helps create the vacuum seal around the nipple.
How do I know what size flange/shield to buy?
You need to measure your nipples. Most pumps have sizing charts and your lactation specialist will have great advice here.
Is my flange/shield size going to change?
It might! Many women experience the need to change their flange size.
What is the Affordable Care Act?
Under The Affordable Care Act (ACA), all accredited insurance plans must provide coverage for essential health benefits, including maternity and newborn care. According to the Centers for Disease Control and Prevention, breastfeeding is one of the most effective preventative measures that mothers can take to protect their health and the health of their children. Many health plans began to implement maternity and newborn coverage on or after August 1, 2012.
What does this legislation mean for me?
If you have an ACA accredited health insurance plan, this law applies to you. These carriers are now required to provide coverage for maternity and newborn care, which includes breast pumps. Health insurance plans are required to offer coverage of breast pumps, but they may not cover the entire cost. Coverage amounts vary according to your plan and provider.