Aetna changes breast pump policy for the better!

Categories: Breastfeeding, Pregnancy, Pumping
August 4, 2020

Being an Aetna in-network breast pump provider, Acelleron is excited to learn that Aetna has revised their Breast Pump Clinical Policy Bulletin to state that a “replacement standard electrical breast pump is considered medically necessary for each subsequent pregnancy, for initiation or continuation of breastfeeding during pregnancy or following delivery.”

Previously, Aetna only covered one breast pump every three years since the Affordable Care Act went into effect back in 2013. This brings Aetna’s coverage in line with most of the insurance companies we work with.

  • Aetna considers “a manual or standard electric breast pump medically necessary during pregnancy or at any time following delivery for breastfeeding.”
  • Aetna considers “a manual or standard electric breast pump medically necessary for women who plan to breastfeed an adopted infant when the above listed criteria are met.”

If you qualify for a replacement breast pump through Aetna, click here to submit your order.

It is also important to understand that some Aetna plans do not follow the Affordable Care Act requirements for coverage of breast pumps. This includes grandfathered plans, or otherwise exempt plans. Employers with grandfathered plans may choose not to cover breast pumps, or include cost share (deductible, copay or coinsurance).

Lastly, Aetna’s policy on breast pump replacement supplies remains the same: “for comfort and convenience (replacement polycarbonate bottle; replacement cap, nipple or lid for breast pump bottle; and replacement locking ring) are not covered.”

Order your breast pump today!

About Aetna and CVS Health

Founded in 1853 in Hartford, CT, Aetna is one our nations’ largest commercial and Medicaid health insurance providers for individuals, employers, health care professionals, and producers. Aetna is now a subsidiary company of CVS Health Corporation.

CVS Health is the nation’s premier health innovation company helping people on their path to better health. Whether in one of its pharmacies or through its health services and plans, CVS Health is pioneering a bold new approach to total health by making quality care more affordable, accessible, simple and seamless.