PENNSYLVANIA — In celebration of National Breastfeeding Awareness Month, the Pennsylvania Insurance Department Deputy Commissioner, Shannen Logue, emphasized the coverage provided for breastfeeding support, equipment, and counseling under the Affordable Care Act. Insurance companies under PID’s jurisdiction must adhere to these coverage requirements. Logue highlighted that worrying about the financial aspect of breastfeeding essentials should not be a concern for parents, as most insurers are mandated by the federal government to cover these vital supports. PID remains committed to ensuring comprehensive coverage for these essential services.
“We want to remind consumers that the federal government requires most insurers to cover many breastfeeding supports and services,” said Logue. “Welcoming a child can be an exciting and overwhelming experience for parents, and breastfeeding can come with its own unique challenges. Worrying about how to pay for breastfeeding essentials such as pumps and counseling should not be one of them. PID is committed to assuring that these essential supports are covered.”
Under the Affordable Care Act, most health insurers are required to cover breastfeeding equipment and counseling for the duration of breastfeeding, and these benefits may be provided before and after birth.
All insurers offering plans on Pennie®, the commonwealth’s official online health insurance marketplace, cover the cost of a breast pump, either a rental or a new unit. Specific plans will have guidelines on the type of covered pump (manual or electric), the number of pumps that are covered, the length of rental (if applicable), and when it will be received. All insurers on Pennie also cover breastfeeding counseling and supplies, and some also cover breast milk storage.
Additionally, all insurers offering coverage on Pennie must cover specific breastfeeding support services without cost-sharing. No cost-sharing means that the consumer will not be charged an out-of-pocket copayment, deductible or coinsurance for these services.
“We encourage insurers to make pregnant and new parents aware of their breastfeeding benefits to make the new family or family addition transition as seamless as possible” added Logue. “Policyholders shouldn’t have to struggle with insurance benefits to optimize their breastfeeding experience.”
Any consumer who has received breastfeeding support or equipment on a no cost-sharing plan and was charged a copayment, coinsurance, or deductible should contact their health insurer to request a refund. The number for the insurer can usually be found on the back of the health insurance card. Consumers are also encouraged to contact the Insurance Department if they have any questions on coverage of breastfeeding equipment or counseling or need assistance.
Consumers with questions on coverage of breastfeeding benefits, or any questions on their health insurance may contact PID online at insurance.pa.gov or call the department’s Consumer Services Bureau at 1-877-881-6388.
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