BCBS - you rock my world

I don't think I have ever heard anyone say, insurance co, you rock my world, so please allow me to be the first.

BCBS you rock my world!

On Friday after some soul searching and discussion with Steve about our commitment to nursing Caroline, I did some calling around to inquire about renting a pump. How much it would cost? Will it help get us out of this milk drought? I got a call back from a lactation consultant at Saint Vincent's who asked me first if my insurance might cover the cost of a pump because rentals are often quite expensive, sometimes as much as 75 bucks a month - holy crap!

Insert ah ha moment - I had called my insurer way back when Caroline was still Cash to inquire about my maternity benefits and I asked this very question. At that time they indicated that it would be partially covered if deemed medically necessary by a physician. When we first started out, she was doing great and getting a prescription from my OB would have taken more than some begging and eye batting. Nursing was going great, so I never gave it another thought. BUT I should have. Back when her doctor was concerned about her weight gain, I should have revisited this because the primo pump would have certainly assisted me in maximizing my milk supply. So we missed that boat and here we are now with barely enough milk to send her to school each day and it did not even occur to me to consider that my insurer might still cover the cost.

The customer service person at my insurer listened carefully and researched our policy, turns out they will cover 90% of the cost for durable medical equipment up to $3500 per year! 90%!!! She located a local medical supply vendor within their network and provided me with the fax number to send the prescription.

My OB office was closing in less than 10 minutes and did not think they could get the prescription completed in that time, so it would likely be Monday before I heard anything back. For the record, I still have NOT heard back from them. It was Steve who suggested I get in touch with those fabulous people at Breastfeeding Resources, who ultimately did call in the prescription for me, though not in time for me to get the pump that day. More importantly Dr. Smilie offered additional information about increasing my supply and how to work and nurse at the same time. She wanted to make sure that this pump would help correct the problem and she thinks that it and the strategies she provided will! I love those people! Thanks to JEN again for sending me their way!!!

So yesterday - Caroline and I in our sickdom drove out to Monroe to pick up the pump and were brutally rebuffed by the store who "does not bill insurance for pumps, they are considered an over the counter pay out of pocket purchase." I took my prescription, called my insurer and they located another company for me to try. This second place did not have the pump I want/need in stock, they are more of a rental place, but they were willing to order it for me, for $516 - HI - it costs about $300 in the store?!?! HOLY MARK UP!!! So they ordered it for me, they will bill my insurance and I will pay for my 10%, which is still less than the $300 I would pay in the store. At this point with just a few more months of nursing ahead of us, I cannot justify the cost of the primo pump, but for $50, just a bit more than it would cost to replace my manual again (which I am sure we would have to do anyway), well that I can definitely justify!

Steve and I were talking about this after it was finally ordered and Caroline and I were on our way home, some 4 hours since leaving the house, and must I remind you sick sick sick! With my stuffy nose all my questions sounded more like, "I'mah here for a breast pumpt. Can you order oned ford me?" I love our insurer for offering this coverage and I know that many women are not lucky enough to have this option. That was only half the battle though, locating an in-network provider proved to be challenging and then convincing that provider to order one took some real self-advocacy on my part. "No, I really need the one she prescribed, the rental is too large to take into the office with me." The difference of 20 dollars between the 10% retail cost and the jacked up home care supply company doesn't make me mad, the fact that the home care supply place can jack it up that high - over 200 dollars more than retail is absolutely mind boggling. So the insurance company will have to pay more for us to have this pump than if they authorized reimbursement for one bought retail. The money they lose by sending us to a provider is more than made up I am sure by the other women who are not able to be as persistent. If I did not have Mondays off and the entire day to devote to this, would it have happened? Probably not.

So ladies, check your policies! Ask about your coverage for durable medical equipment and if a breast pump might qualify. Be persistent! Advocate for yourselves!

In just 3-5 business days I am expecting my work life to vastly improve when I am not faced with struggling to pump at work for 30 minutes a pop between meetings. With the help of this fabulous pump, I will get more milk in less time Pump in Style Advance.

It was a toss up this morning about whether to write about this or the sickness that still inhabits our house - look for a sick update later - including a discussion with Sarah about to whom we should direct our gratitude for the projectile vomit and hacking cough that made me think that I would discover a little coughed up lung in the back seat when I removed Caroline from the car this morning. Run on schmun on, an angry mom need not take a breath to express herself. Caroline is at school, but probably not for the whole day. I plan on leaving work to take care of myself and get myself on the mend a bit before picking her up a bit earlier than usual.


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