Health Care

Breast pumps, nursing supplies to be covered by Tricare

Tricare will begin covering the cost of breast pumps and lactation counseling services for new moms starting July 1.

Under an update to the Tricare policy manual released Friday, the military health program will expand lactation benefits for new mothers to include manual or electric breast pumps, some supplies and outpatient counseling services.

The change is retroactive to Dec. 19, 2014, so Tricare beneficiaries who obtained these supplies or services on or after that date may be eligible for reimbursement if they meet the requirements.

According to the new policy, Tricare will cover — at no cost or co-payment — one manual or standard electric breast pump per birth as well as supplies such as power adapters, storage bags and special bottles to beneficiaries with a prescription.

Breast pump kits also are covered, as are outpatient lactation counseling services — up to six sessions — provided the counseling is done by a Tricare-approved provider.

Covered items must be obtained from a Tricare-authorized provider, supplier or vendor to be covered, but according to Tricare, any civilian store or pharmacy meets that criterion.

If items are purchased at a retail store or online, beneficiaries need to file a claim for reimbursement.

To be eligible for reimbursement, Tricare beneficiaries must file a claim form along with a current prescription and itemized receipts for equipment and supplies.

The fiscal 2015 National Defense Authorization Act mandated that the Defense Health Agency change its lactation coverage policies to align them with the provisions of the Affordable Care Act, which requires private insurers to cover rental or purchase of breast pumps, support and counseling at no cost.

The new policy also provides for coverage of hospital-grade breast pumps for moms whose infants are unable to nurse directly because of illness, birth defects, adoption or other medical conditions.

It does not pay for supplies such as batteries and battery packs, regular baby bottles, travel bags, cleaning supplies, nursing bras and pads and other tangential nursing items, such as specialty garments or medicated ointments.

A Tricare official said more details on the benefit and its implementation will be released sometime in the next two weeks.

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