The article had some basics but I was still not sure what it all meant so I did a little research and well, I am still confused. Ha. You thought I was going to tell you something amazing right? Nope. The law is super confusing and there are provisions to the provisions and none of it makes sense, yet.
So, after intense Internet research failed, I decided to try calling a "benefits coordinator" at United Health Care. UHC is the provider of state employees here in Ohio and also our insurer. I am even enrolled in their special "maternity" program so I thought for sure that they would at least be able to clear up my own benefits. Yeah not so much. The conversation went something like this:
Me: Hi, I am calling to find out about the breastfeeding programs that I am entitled to under the new Affordable Care Act
Rep: Oh, yes, let me check.
Rep: Ok, well, I checked your benefits and at this time your plan does not cover any of the services in the new law.
Me: Hmm, well why is that? It's a law, shouldn't it be covered?
Rep: Yes, I understand your confusion, however, your plan started July 1, 2012 so it was grandfathered in to the old terms. You can try calling back on July 1 to see if they will cover it then.
Me: I understand that there is no coverage for the actual breast pump or supplies but do I have lactation consultations services?
Rep: No, those are not covered either. You will need to call back on July 1st to see if there are any changes.
Me: [cheerfully] Sure, thanks.
There we go friends. Clear as mud. I am so glad that I was able to bring you this good news.
But seriously, I was very disappointed. As a working mom, who uses lactation consultants and puts extra miles on her breast pump, getting a high quality breast pump could really help me out. The one that I have is old (very old), but I can't really justify spending $300 on a new one. Nor do I think this little one will hang out until July 1st to be able to benefit from the lactation services that may or might not be covered.
In the end, what I have gleamed from the Internet articles and talking to the UHC rep is this:
- As of January 1st, the Affordable Care Act mandates that free and low cost breast pumps are covered by insurers.
- Not all insurers have to participate. Some are "grandfathered" in to the old policies.
- Not all insurers will be providing free breast pumps, some will only be providing rental coverage.
- If you can get insurance to pay, you can't just walk into any local store and buy a breast pump. You must buy it from an approved insurance provider.
- Many companies are scrambling to get lactation consultants as approved providers but most lactation consultants don't want to sign. So you might not be getting high quality services.
Pregnant? Planning on nursing? Now would be a good time to research this new benefit and see how it applies to you. For now, I am going to cross my fingers and hope that July 1st brings better news for me.
I waded through a lot of articles but this one from the Washington Post is probably the most informative.
Tell me, does a free breast pump sound like a necessary benefit? Were you surprised to learn that this is part of the Affordable Care Act? Do you plan on using this benefit if necessary?
What are your thoughts about it?