Tricare and BF

[laece]

So how would I go about finding a breast pump that Tricare approves and would run through insurance?

[laece]

For sure!!

[headoverheels]

Well this is good to know.

[reesarice]

Has anyone had any luck with this?

[tjr42px]

Good morning ladies. A dad here with nothing to add at the moment. But, I am a provider in an MTF. I'd be happy to ask our other docs and Tricare folks about this for you. My wife's insurance covered her breast pump and supplies prior to us becoming military, so I'm not sure the process. But I will see what I can dig up. Calling Tricare is a hassle...I know. But since I can press the "if you're a provider in an MTF" button I might be able to get somewhere.

[tjr42px]

So I have little to add except some explanation why Tricare is functioning poorly aka...totally sucks.

As the OP mentioned the NDAA for 2015 does mandate lactation supplies to be covered. The bullshit part is that although congress signed that act (effectively making a mandate) they have yet to sign a budget line item that authorizes the release of funds for the mandate. Essentially they are signing things as they are presented and approved. The mandate has come before the finances in this case.

I spoke to a few of our family practice nurses and a family advocacy nurse who all told me the same thing. They are advising people to buy and then save recipes with the understanding they will likely be reimbursed. I pressed the issue in that "likely" and "probably" are not good answers. They can't say for sure because they don't know if a specific brand is on an approved list of retailers for the simple reason that DHA and Tricare haven't created one.

A PA friend is checking into it and I have an email into a former supervisor who now works at DHA. She isn't doing work related to this, but may help us make a contact with people who are in the know. Sorry I don't have better news, but I'm still working it.

[tjr42px]

So tricare is as tricare does. I'm still waiting to hear from my contact at DHA, but tricare reps told me it's not covered. "Unless it is posted on our coverage page it isn't covered." They had no answer for the facebook post, the defense act mandate, or the few articles I linked to that have quotes from TRICARE upper management saying reimbursement will occur for authorized purchases. There is no list of authorize dealers and until there is, it appears they are acting like nothing is changing.

Sorry ladies. My best advice is if you want to buy, buy and keep the receipts. Unfortunately if it turns out similar to the current coverage (for premies) they will only cover hospital grade pumps. Which if you can afford the upfront cost no biggie if you will be reimbursed. But if you don't get reimbursed you probably would have gone for something less expensive. Or if the upfront cost is too great then you'll get a less expensive pump but it won't be covered.

I can't say for certain, but my guess is everything will be reimbursed that is purchased before the list is released because there is no way to know what will it won't be included. After the authorized list is created then only those retailers will be reimbursed. I know that isn't much and is very frustrating. Wish I could give you something more positive or at least concrete. I'll let you know when DHA contact comes through.

[Deleted]

So excited about the new policy! I can finally get a new pump!

[Deleted]

So I just wanted to update you gals on the process I went through for getting my pump. I got my Rx from my OB and sent it and a request form into one of the lactation groups that TRICARE endorses called Tidewater Lactation Group. On 7/29 they let me know they got my submission I had emailed a couple hours earlier and that they would let me know when my pump was shipped. I got an email today that it has officially been shipped off to me. No hassle, no issues, no submitting multiple anything. I have been very pleased.