The Aetna breast pump benefit helps new and expecting mothers access essential breastfeeding equipment at no cost. Thanks to the Affordable Care Act (ACA), most Aetna plans cover breast pumps and related supplies.
This article explains how to get your pump, what’s covered, and tips for a smooth process in 2025.
What Is Aetna’s Breast Pump Coverage?
Aetna, a CVS Health company, offers breast pump coverage under most health plans. The ACA mandates that insurers cover breastfeeding support, including pumps, as a preventive benefit. This applies to new and non-grandfathered plans starting after August 1, 2012.
Coverage includes manual or standard electric breast pumps during pregnancy or while breastfeeding. Aetna also supports adoptive mothers planning to breastfeed. Some plans may not follow ACA rules, so check your policy details.
Why Breast Pumps Matter
Breast pumps allow mothers to provide breast milk even when apart from their baby. They support working moms, help maintain milk supply, and ensure infants get breast milk’s health benefits. These include stronger immunity and reduced risk of infections.
Pumps offer flexibility and convenience. They’re especially helpful for premature infants or those in the NICU. Aetna’s coverage makes this vital tool accessible without financial stress.
Types of Breast Pumps Covered
Aetna covers manual and standard electric breast pumps, considered durable medical equipment (DME).
Manual pumps are hand-operated, ideal for occasional use. Electric pumps, like double electric models, suit frequent pumping.
Hospital-grade pumps are covered for rental if a newborn is hospitalized, such as in the NICU. Wearable or battery-operated pumps, like Willow, may require out-of-pocket costs unless medically necessary. Check your plan for specific brands like Medela or Spectra.
Eligibility for Aetna Breast Pump Coverage
Most Aetna members qualify for a free breast pump per pregnancy. This includes expecting mothers, new moms, and those breastfeeding adopted infants. Coverage starts during pregnancy or after delivery and continues while breastfeeding.
Grandfathered plans or exempt employer plans may not offer this benefit. Self-funded plans might have different rules. Always verify eligibility through Aetna’s member portal or customer service.
How to Get Your Aetna Breast Pump
Getting an Aetna breast pump is straightforward with the right steps. You’ll need to work with an in-network DME provider, like Aeroflow Breastpumps or The Breastfeeding Shop. Here’s the process:
- Verify Coverage: Check your plan via Aetna’s website or call (800) 872-3862.
- Get a Prescription: Obtain one from your doctor, midwife, or nurse practitioner.
- Choose a Supplier: Select an in-network provider for no-cost delivery.
- Place Your Order: Submit insurance details and prescription online or by phone.
Prescription Requirements
Aetna requires a prescription from a licensed healthcare provider for breast pump coverage. The prescription should include your name, due date (if pregnant), and pump type (manual or electric). Some suppliers, like Acelleron, can request this for you.
Ensure the prescription is sent to your chosen DME provider. Without it, your claim may be denied. Keep a copy for your records.
In-Network Suppliers and Brands
Aetna partners with DME providers to deliver breast pumps at no cost. Popular suppliers include Aeroflow Breastpumps, Byram Healthcare, and Lenox Breast Pumps. They offer brands like Medela, Spectra, Ameda, and Lansinoh.
Some plans cover upgraded models, like Elvie or Willow, with an out-of-pocket fee. Suppliers verify coverage and handle claims, simplifying the process. Always use in-network providers to avoid unexpected costs.
Breast Pump Supplies Covered
Aetna covers essential breast pump supplies per pregnancy. These include tubing, valves, flanges, bottles, and breast milk storage bags. Replacement parts are often covered monthly to maintain pump functionality.
Items like cleaning wipes, nursing bras, or travel bags are typically not covered. Check with your supplier for a full list of included accessories. Milk Moms and Yummy Mummy specialize in supplying these extras.
Lactation Support Services
Aetna covers up to six lactation consultant visits under most plans. These sessions, offered by in-network OB/GYNs or pediatricians, help with breastfeeding challenges like latching or low supply. Virtual or in-person options are available.
Lactation support is part of the ACA’s preventive care benefits. Confirm coverage through your plan documents. These visits can boost confidence and breastfeeding success.
Key Coverage Details
Below is a table summarizing Aetna’s breast pump and related benefits in 2025:
| Benefit | Details |
|---|---|
| Breast Pump | Manual or standard electric pump per pregnancy, free via in-network supplier. |
| Hospital-Grade Pump | Rental covered if newborn is hospitalized (e.g., NICU stay). |
| Supplies | Tubing, flanges, bottles, and storage bags; monthly replacements often covered. |
| Lactation Consultant | Up to six visits, in-network, at no cost. |
| Prescription Requirement | Needed from a licensed provider; supplier may assist. |
This table helps you understand what to expect from your plan.
Timing Your Order
You can order your Aetna breast pump during pregnancy or after delivery. Suppliers often ship pumps 60 days before your due date, giving you time to practice. Post-delivery orders are processed quickly, typically within days.
Order early to avoid delays, especially during busy seasons. If breastfeeding an adopted infant, order once you start induced lactation. Contact your supplier for exact timelines.
Upgrading Your Breast Pump
Some mothers want advanced pumps, like wearable models from Willow or Elvie. Aetna may cover the cost of a standard pump, with you paying the difference for upgrades. Suppliers like 1 Natural Way outline upgrade costs clearly.
Discuss options with your provider. Upgrades can cost $50 to $200, depending on the model. Ensure the pump meets your lifestyle needs, like portability for working moms.
Avoiding Common Issues
Mistakes can delay your pump delivery. Using out-of-network suppliers may lead to denied claims or extra costs. Not submitting a prescription is another common error.
Double-check your plan’s coverage and supplier’s in-network status. Keep copies of your prescription and order confirmation. Contact Aetna if you face claim issues.
Special Cases and Exceptions
Aetna covers hospital-grade pump rentals for medical necessity, like a baby in the NICU. For adopted infants, pumps are covered if you’re inducing lactation. Documentation from your doctor may be required.
Grandfathered plans may exclude breast pump coverage. If your employer’s plan is exempt, you might face copays or no coverage. Call Aetna to clarify your benefits.
Tips for Choosing the Right Pump
Selecting a breast pump depends on your lifestyle. Manual pumps suit occasional use, while electric pumps are best for frequent pumping. Consider portability if you travel or work.
Consult a lactation expert or supplier for advice. Read reviews on brands like Spectra or Medela. Test the pump before your baby arrives to ensure comfort.
Why Aetna’s Coverage Stands Out
Aetna’s breast pump benefit aligns with its focus on women’s health. The no-cost pump and supplies reduce financial burdens for new moms. Six lactation visits provide extra support for breastfeeding success.
The wide network of DME providers ensures easy access. Free shipping and claim handling by suppliers save time. Aetna’s commitment makes breastfeeding more manageable.
Summary
The Aetna breast pump benefit provides expecting and new mothers with a free manual or electric pump per pregnancy, thanks to the ACA. Coverage includes supplies like tubing and storage bags, plus up to six lactation consultant visits.
Order through in-network suppliers like Aeroflow or Byram Healthcare, with a prescription from your doctor.
Verify your plan, avoid grandfathered plan limitations, and order early for a hassle-free experience. Aetna’s support empowers moms to breastfeed confidently in 2025.
FAQ
What does Aetna breast pump coverage include?
Aetna covers one manual or electric breast pump per pregnancy, plus supplies like tubing and storage bags. Hospital-grade pump rentals are covered for hospitalized newborns. Up to six lactation consultant visits are included.
How do I get a free breast pump from Aetna?
Verify your coverage, get a prescription, and order through an in-network supplier like Aeroflow Breastpumps. Submit insurance details and the prescription online or by phone. The pump ships free.
Do I need a prescription for an Aetna breast pump?
Yes, a prescription from a doctor, midwife, or nurse practitioner is required. It should include your name, due date, and pump type. Suppliers can often request it for you.
Can I get a Willow or Elvie pump with Aetna?
Some plans cover standard pumps, with an out-of-pocket fee for upgrades like Willow or Elvie. Check with your supplier for costs, typically $50 to $200. Verify coverage first.
Are breast pump supplies covered by Aetna?
Yes, supplies like tubing, flanges, bottles, and storage bags are covered per pregnancy. Monthly replacements may also be included. Non-essential items like cleaning wipes are not covered.
What if my Aetna plan doesn’t cover a breast pump?
Grandfathered or exempt plans may not cover pumps or may require copays. Call (800) 872-3862 to confirm your benefits. You may need to pay out-of-pocket if excluded.
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