It was 7 years ago when I walked into the Tricare representative’s office at the Naval hospital in Okinawa and asked this question:
How can I get a breast pump?
At the time I was pregnant with my oldest and stationed in Japan. My civilian friends who had recently had babies told me to save my money and to not buy a breast pump. Their insurance companies paid for their breast pumps and surely, Tricare would pay for mine.
The Tricare rep kindly explained to me that no, at that time, Tricare didn’t cover breast pumps. I was disappointed (especially considering how many military couples were having 2-baby tours on Okinawa), but accepted the policy.
Since then Tricare has changed their policy.
Tricare now covers breast pumps and breast pump supplies for new mothers who have a prescription from a Tricare-authorized physician, physician assistant, nurse practitioner or nurse midwife. This policy went into effect in July 2015.
This policy change is also retroactive, so if you purchased a breast pump since December 19, 2014, you can submit a claim for reimbursement.
How do I get Tricare to pay for my breast pump?
The first step is to get a prescription.
This prescription must be from a Tricare-authorized health care provider. See the list above. Make a copy of your prescription for your records. Your prescription shouldn’t be for a specific manufacturer, brand or model number, but it must show if you’re getting a basic manual or standard electric pump, according to the Tricare guidelines.
If you qualify for a hospital-grade pump, Tricare advises that you work with your provider and your regional contractor to get a referral and authorization.
Once you get your prescription, the next step is to decide how you plan to get your breast pump.
The Tricare guidelines said “If you don’t want to pay up front, contact your regional contractor to find a network provider or supplier. You need to show your prescription.” In this case, you won’t need to file a claim.
If you are willing and able to pay for your breast pump upfront, you can buy it from any breast pump supplier. There isn’t a list of approved providers. That means you can buy it from any of the following:
- Post Exchange (PX), Base Exchange (BX), or Station Exchange run by the The Army/Air Force Exchange Service (AAFES); The Department of the Navy; The United States Marine Corps; or The United States Coast Guard
- Civilian stateside and overseas retail stores (such as Walmart, Target, Babies”R”Us, CVS)
- Online store (such as Amazon.com, Overstock.com; standard shipping and handling is covered)
You won’t need to show your prescription at the time of purchase. Make a copy of your receipt and save it. You’ll need it when you file your claim for reimbursement.
Let’s say you choose to get your breast pump through a military clinic or hospital, then simply follow their procedures.
How do you file a claim for your breast pump?
For those of you who plan to buy a pump or have paid for one out-of-pocket since December 19, 2014, complete a DD Form 2642, attach a copy of your prescription and receipt and then mail it to your Tricare claims processor. Your reimbursement check is mailed to you.
Besides breast pumps, the policy also includes breast pump supplies. You can get these items before or after delivery. Here is a list of what is covered:
- Standard power adapters
- Tubing and tubing adaptors
- Locking rings
- Bottles (that are used with the breast pump, not regular baby bottles)
- Bottle caps
- Shield/splash protectors
- Storage bags
Tricare doesn’t pay for extra breast pump batteries, nursing bras, over-the-counter creams, ointments and other products that relieve breastfeeding-related symptoms or breast pump cleaning supplies.
This policy applies to all Tricare-eligible female beneficiaries. It is available to you no matter which Tricare plan you use (Tricare Prime, Standard, Reserve Select, U.S. Family Health Plan, etc.) or your sponsor’s status (active, retired or Guard/Reserve).
Tricare covers one breast pump per birth event. If you received a breast pump when you were pregnant last year and you are pregnant again, you can get a new breast pump.