Getting A Free Breast Pump With TRICARE
You may have heard that TRICARE will give you a free breast pump when you have a baby. But, you might also have some questions about how this all works, what you need to do to get your pump, and any other details about the benefit. Here is what you need to know about getting a breast pump with your TRICARE benefit:
What Does TRICARE Cover With The Breast Pump Benefit?
TRICARE covers breast pumps and breast pump supplies.
Who Is Eligible For The Breast Pump?
Any female TRICARE beneficiaries that have a birth event. A birth event is a pregnancy or when someone legally adopts an infant and intends to breastfeed the infant. This benefit is for those who have TRICARE Prime, TRICARE Select, TRICARE Reserve Select or any other TRICARE plan. Your service member can be active duty, retired, or guard/reserve.
Where Can You Get The Breast Pump?
The awesome thing about this benefit is that you can get your breast pump from a lot of different places. You can get one from a network or durable medical equipment provider, the Commissary, the Post Exchange (PX,) Base Exchange (BX,) or Station Exchange run by The Army/Air Force Exchange Service (AAFES,) The Department of the Navy, The United States Marine Corps, or The United States Coast Guard. You can also get them from a civilian stateside or overseas retail store, or an online store where standard shipping and handling are also covered.
There is no specific list of approved providers, however, if you are going to get your breast pump from a retail store, going with a store that knows about the TRICARE benefit and what to do is a good idea.
How Do You Get Your Breast Pump?
There are a few steps you need to take in order to receive your breast pump.
- Step One – Get a prescription. This must be from a TRICARE-authorized doctor, nurse midwife, physician assistant, or nurse practitioner. Your prescription must show if you are getting a basic manual or standard electric pump. In order to qualify for a hospital grade pump, you would need to have a special referral and authorization. You will need a diagnosis code on the prescription if you plan to get your breast pump from a network provider or durable medical equipment supplier.
- Step Two – Your next step is to find the pump that you want and the place you want to get the pump from. You can contact your regional contractor in order to find a network provider or supplier. You would then need to show them your prescription. Some retailers have a form for you to fill out so that you can easily get your pump after you submit your information and prescription. If you are going to go with a military clinic or hospital, you would need to follow their procedures to get your breast pump.
- Step Three – If you would like to purchase your breast pump ahead of time and then receive a refund, you would need to submit a DD Form 2642, as well as a copy of your prescription and receipt. If you don’t have a receipt you will not be able to be reimbursed. In addition, if you were not eligible for the breast pump when you bought the breast pump, you can not get a refund. The date on your prescription can be after the date on your receipt. You would then mail all of your paperwork to your TRICARE claims processor and you will then receive a check from your regional contractor.
Can You Get Any Breast Pump You Want?
TRICARE will pay up to a certain amount for a breast pump and initial breast pump kit. As of March of 2019, the rates are $312.84 for stateside and $500.55 for overseas. The rates may change every year. This benefit is not limited to a specific manufacturer, brand, or model number.
What Breast Pump Supplies Are Covered?
According to TRICARE, these breast pump supplies are covered:
- One breast pump kit per birth event. The kit may not be separately billed for and reimbursed.
- Standard power adapters: 1 replacement per birth event, and not within 12 months of the breast pump purchase date.
- Tubing and tubing adapters: 1 set per birth event.
- Locking rings: 2 every 12 months
- Bottles: 2 replacement bottles and caps/locking rings every 12 months following the birth event
- Bottle caps: 2 every 12 months after the birth event
- Storage bags: 90 bags every 30 days following the birth event
- Valves/membranes: 12 for each 12 months following the birth event
- Supplemental Nursing System (SNS): 1 per birth event when a physician prescribes
- Nipple shields/splash protectors: 2 sets (2 shields/set) per birth event when a physician prescribes
You can also receive more of the amounts listed above when your provider prescribes them and when medically necessary. You would need new prescriptions when you need replacement supplies that exceed the limits.
Where Can You Get Your Breast Pump Supplies?
You can get your breast pump supplies at all the same places you could get your breast pump at. You would use the same process as you do for getting your breast pump.
What Happens If Your Breast Pump Breaks?
You can get the pump replaced under certain conditions. You would want to contact your regional contractor for more information.
Can You Get A Breast Pump For Each Baby?
Yes, TRICARE allows you to have one breast pump per birth event.
When Can You Get Your Breast Pump and Supplies?
You can get them starting at 27 weeks or up to three years after the birth event. The three year period starts on the child’s birth date or the date of legal adoption.
All of this information is based on the March 2019 update of this TRICARE benefit which you can read more about here.
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