How to get a breast pump through TRICARE
From 27 weeks pregnant: one pump per birth, supplies for up to three years.
How do I get a breast pump through TRICARE?
Get a prescription, then order from a supplier. TRICARE covers "one manual or standard electric breast pump per birth event," starting at 27 weeks pregnant, plus certain supplies for up to three years after the birth. TRICARE says "you pay nothing for covered breast pumps and supplies you get from network providers and network DME suppliers."
TRICARE covers a breast pump and certain supplies for new and expecting mothers. A few details, like what the prescription says, make the order go smoothly.
Steps
- Check when you qualify. You may qualify if you're at least 27 weeks pregnant, you've given birth, or you legally adopt an infant and intend to personally breastfeed.
- Get a prescription. It can come from a TRICARE-authorized doctor, physician assistant, nurse practitioner or nurse midwife. It must say manual or standard electric pump.
- Supplies need their own list. A prescription for supplies must say which supplies you need.
- Know the supply limits. TRICARE sets how many of each supply you can get and how often. You can get more if your provider prescribes them as medically necessary.
- Hospital-grade pumps. When it's medically necessary, a hospital-grade pump can be rented. Work with your provider and TriWest for a referral and authorization.
- Ask about the network. Covered pumps and supplies cost nothing from network suppliers. From non-network suppliers or stores you may pay up front and file a claim.
- What isn't covered. Batteries and battery packs, nursing bras, cleaning supplies, travel bags and extended warranties.
Checklist
- At least 27 weeks pregnant, given birth, or adopting
- Prescription says manual or standard electric pump
- Supplies prescription lists each supply
- Asked whether the supplier is in the TRICARE network
- Called intake or sent a request
If your pump breaks, TRICARE may cover a new one under certain conditions. Intake or TriWest can tell you what's needed.
In TRICARE's words
One manual or standard electric breast pump per birth event
You can get covered supplies starting at 27 weeks pregnant and for up to three years after the birth event.
You pay nothing for covered breast pumps and supplies you get from network providers and network DME suppliers.
Equipment in this guide
Follow the instructions from your doctor and the equipment maker.