Pittsburgh Nesties

FYI: UPMC Insurance and breast pump...

I know this was a question that I had posted earlier and just wanted to let you know that UPMC does cover a Medela Pump in Style Advanced Shoulder Bag for breastfeeding moms who are returning to work/school.  It was delivered today via the Home Medical Equipment company.  Email me at kristininpa at gmail dot com if you have any questions...
ourblackandgoldworld.blogspot.com

Re: FYI: UPMC Insurance and breast pump...


  • that's nice... I tried with my insurance (BBBS) and was told it wasn't covered.  That seems so stupid!!!
    image AlternaTickers - Cool, free Web tickers
  • Nice to know. I never tried to get a pump, but when I was in the hospital, Magee gave me a manual pump and all the hook ups to a pump if I was interested in renting one.?

    Image and video hosting by TinyPic

    Lilypie Kids Birthday tickersLilypie Third Birthday tickers
  • I think it might depend on what plan you have. I checked, and they wouldn't cover one for me.
    image
  • image valkaz:
    I think it might depend on what plan you have. I checked, and they wouldn't cover one for me.

    That's what they told me EVERY TIME I CALLED (I seriously called like 10 times b/c I kept getting the run around from them each time).  They kept telling me it wasn't covered then the double electric wasn't covered, etc, etc.  However, I had my OB do the OB Needs Assessment Form (this is new for regular UPMC insurance as of the past year or so...before, they only wanted it filled out for the UPMC for You insurance holders) which would automatically trigger them calling you to follow up. 

    The woman who called to follow up told me it's 99.9% of the time covered for women with UPMC insurance going back to work and that most people don't know that and she told me exactly what the script needed to say (even after talking to the Member Services people after knowing this information, they still said it wouldn't be covered).  When I had the script, I faxed it in as she said to do.  I then called the Member Services, gave them the billing code for the medical reason.  Member services verified full coverage and said it would be processed that day.  Got the call from the Home Health Company later that afternoon and they said they would get it in the mail to me the next day.

    So, yeah, I don't believe a word the Member Services people tell me b/c I was told every time it wasn't covered.  Then, when I had a medical reason billing code (for maternal/infant separation due to work), voila, it was fully covered.

    ourblackandgoldworld.blogspot.com
  • Well Val had a late term preemie and I was DENIED as well and I had preemies.  I am glad that it worked for you but I am rather annoyed that your situation got covered but someone with NICU babies didnt get covered-KWIM? I am glad for you but I dont understand the logic of covering you, when yours is a fairly common situation, but not covering women with preemies. I even had the NICU staff fighting for me. 

    Baby Birthday Ticker Ticker Mommy to twin girls, Ashlyn & Fiona, born at 34 weeks due to vasa previa.
  • the current policy states that ALL UPMC health insurance users get a pump.  I am appalled that Jo and Val were not able to get one, if anyone should have, you guys should have. The fact that you had preemies is pretty much an automatic reason to get one. You HAD to pump. Yes, there are some certain terms and reasons you have to have on the script for the pump in order to get a double electric, but there is seriously no reason that you and Val didn't get one. Even bad latch is a reason to get one. Grrrr.

    image MrsARC1105:

    Well Val had a late term preemie and I was DENIED as well and I had preemies.  I am glad that it worked for you but I am rather annoyed that your situation got covered but someone with NICU babies didnt get covered-KWIM? I am glad for you but I dont understand the logic of covering you, when yours is a fairly common situation, but not covering women with preemies. I even had the NICU staff fighting for me. 

  • That's great that you were able to figure out a way to get it covered -- it should be covered! It seems to be understood by the medical community that BFing is healthiest for mom and baby, so why would a (costly) medical device designed for that purpose not be covered -- it's BS! We pay so much for insurance and it baffles me the things they consider outside the realm of medically necessary. My insurance (United) wouldn't cover compression hose for me that were prescribed by my OB when I was on bed rest to prevent blood clots from forming in my legs. I think the treatement for resolving issues related to clots would be far more expensive than covering the $50 hose it takes to prevent them in the first place. It blows my mind.
  • Don't forget though, Val and Jo, that you guys had your babies a couple of years ago. It sounds like the insurance has since changed. And while Member Services are still saying "no," they are now wrong. I also worked for UPMC (and had their insurance) at the time of Gavin's birth and I wasn't able to get a pump either.

     

    image


    My three sons.


    Lilypie Kids Birthday tickers


    Lilypie Third Birthday tickers


    Lilypie First Birthday tickers

  • image MrsARC1105:

    Well Val had a late term preemie and I was DENIED as well and I had preemies.  I am glad that it worked for you but I am rather annoyed that your situation got covered but someone with NICU babies didnt get covered-KWIM? I am glad for you but I dont understand the logic of covering you, when yours is a fairly common situation, but not covering women with preemies. I even had the NICU staff fighting for me. 

    Agreed.  If anyone should be covered, it's those women with preemies.  It took Tessa 2 1/2 months to learn how to latch, and I had no choice but to pump. 

    image
Sign In or Register to comment.
Choose Another Board
Search Boards