Does Medicaid cover breast pumps?
Last verified:
In most states yes, as durable medical equipment during or after pregnancy, though the federal rule that requires private plans to cover them does not bind traditional Medicaid. Federal rule: state option under medical supplies.
What federal law says
The Affordable Care Act's women's preventive services requirement, which makes private insurers cover breast pumps, applies to marketplace plans and to Medicaid alternative benefit plans for expansion adults. Traditional Medicaid is not bound by it, so coverage there comes from the state's medical supplies and equipment benefit under 42 CFR 440.70.
Most states cover a manual or standard electric pump once per pregnancy, ordered by a physician or midwife and supplied by a contracted durable medical equipment company, sometimes only after the birth. Hospital-grade rental pumps are covered when medically necessary, for example for a premature infant in intensive care.
WIC also lends pumps to enrolled mothers, which is the fallback where Medicaid's benefit is thin.
Children under 21
Not applicable.
What to ask your state plan
- Ask the OB or midwife to write the order in the third trimester so the supplier can ship before delivery, where the state allows.
- If Medicaid declines, WIC clinics lend electric pumps at no cost.
- Find your state's agency, program name and phone on Medicaid by state.
Related questions
Common questions
Does Medicaid cover breast pumps?
In most states yes, as durable medical equipment during or after pregnancy, though the federal rule that requires private plans to cover them does not bind traditional Medicaid.
Does Medicaid cover breast pumps for children?
Not applicable.
How do I find out whether my state's Medicaid covers breast pumps?
Three places. Your plan's member handbook or benefit summary, which lists the covered services and limits; the state Medicaid agency's provider manual for the service, which is public and states the medical-necessity criteria; and the member services line on your card, which can run a coverage check for a specific procedure code. Our state pages list each agency's phone and portal.
Sources
- 42 CFR 440.70 (home health services, medical supplies and equipment)
- 42 CFR 440.347 (essential health benefits in alternative benefit plans)
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