The Affordable Care Act may have everyone confused and/or in a tizzy, but there are some little-known benefits that have just recently started to take effect. In enrollment meetings we always enjoy letting people know that, thanks to Obama, preventive care (meaning your annual checkup) is now at zero cost as long as you stay in-network. Also, for women, the annual OBGYN visit (complete with pap smear) is free. We’ve even learned that the HPV vaccine for girls is covered gratis.
The list gets better: birth control is now free. So are mammograms at age 40, and colonoscopies for both sexes at age 50. Baby and child immunizations are also covered at 100%, as are well-baby and well-child visits.
And taking things even one step further in the direction towards supporting proactive health, the Reforms have mandated that breastfeeding supplies are free! Pumps, pump rentals, lactation consultations, theoretically even milk storage bags and other paraphernalia are all to be made available at zero cost to new mothers. Anyone who’s ever been lucky enough to breastfeed will tell you that this is a significant development, since those supplies are not cheap!
The trick is to obtain pumps and other supplies/services through an in-network provider. Right now, this is much harder than it sounds. Only a limited number of durable medical equipment facilities even have breast pumps in stock, and the health insurance carriers are themselves only just coming up to speed in terms of implementing the new benefits.
In California, a store called The Pump Station (http://www.pumpstation.com/pumpstation/) has begun helping to supply breast pumps and other materials/services to breastfeeding moms on an out-of-network basis. Out-of-network benefits aren’t at 100%, but can still be reimbursed by the carrier up to 50% at the contracted amount if you submit a claim. The company also helps point you in the right direction on how to submit the claim to your carrier. So if you come up against a brick wall trying to get the in-network benefits to which you’re entitled from your carrier, reach out to The Pump Station and at least get something out of the new mandates! It’s your legal right.