You’ve probably heard the good news by now that the Affordable Care Act requires most insurance companies to cover breast pumps and lactation support for new moms. Depending on your insurance, however, your pump of choice may not be available. Don’t worry — many insurance plans will allow you to upgrade your pump by paying the difference in price. Even more good news: you can use your flexible spending account (FSA) or health savings account (HSA) funds to pay for the upgrade. You can also use FSA/HSA dollars to pay for breastfeeding supplies and accessories.
How FSAs and HSAs Work
FSAs allow you to designate a portion of your paycheck to cover certain types of expenses, such as prescriptions or healthcare visits. The money is deducted before taxes are taken out, so you can buy what you need with pre-tax funds.
An HSA is similar to an FSA, except that it is for people with a high-deductible health plan and the money you contribute carries over from year to year. Expenses covered vary by provider, so check with your employer before applying funds from your HSA to cover medical costs.
Upgrades, Supplies, Accessories
While the Affordable Care Act requires insurers to provide breast pumps with no co-pay, it is up to the health plan to determine which pumps will be offered and what upgrade options will be available. If you would like a different model pump than what is covered by your plan, you may be able to upgrade by paying the difference in price. You will need to talk to your insurance company to confirm this.
In addition to using your FSA/HSA dollars to cover the cost difference for a pump upgrade, you can also use the funds to buy a second pump for convenience at work or on-the-go. And, if you need new parts, additional breastmilk storage bags or other breastfeeding supplies and accessories, you can use FSA/HSA dollars for that as well.
Deadlines to Remember
Open Enrollment: You can change your contribution to an HSA account throughout the year; however, you must choose your annual FSA allocation during the open enrollment period. You should consider how much you will need for upgrades, supplies and accessories while determining how much in FSA funds you and your family will need.
End of the year: Another important deadline for FSA funds is December 31, when all funds must be used. (Some plans may allow a grace period; check with your employer.) As you review your remaining funds and decide how to use them, consider whether you will need supplies, a second pump for going back to work or an upgrade.
Remember that HSA funds roll over from year to year, so you are not obligated to spend the amount you contributed in one calendar year by December 31.
Check out these Medela resources below for more information:
- Read more information on using FSA/HSA dollars to pay for upgrades, supplies and accessories at https://www.medelabreastfeedingus.com/tips-and-solutions/171/flexible-spending-accounts-fsa.
- Find a durable medical equipment supplier near you who accepts your insurance at https://www.medelabreastfeedingus.com/insurance-pump-lookup.
- Prepare for a conversation about breastpump coverage with your insurance provider by reviewing these facts and questions to ask.