Acelleron Medical Products

Category: Insurance

  • Getting a Breast Pump Through MaineCare and Acelleron

    Getting a Breast Pump Through MaineCare and Acelleron

    If you have Maine Medicaid, also known as MaineCare, Acelleron can help you get your free breast pump!

    The Affordable Care Act

    According to the Office on Women’s Health, “The Affordable Care Act (2010) requires most health insurance plans to cover the cost of a breast pump as part of the women’s preventive health services. These rules apply to most commercial and private insurance plans, except grandfathered plans. The majority of state Medicaid plans also cover a breast pump, however because states run their own Medicaid programs within federal guidelines, different states have different rules.”  The good news is, Maine Medicaid covers breast pumps!

    Medicaid logo

    MaineCare Breast Pump Coverage Details

    MaineCare allows you to obtain one electric breast pump per pregnancy at no cost to you. You can place your order with Acelleron at any point during your pregnancy. Keep in mind, MaineCare only allows the pump to be shipped one month prior to your baby’s due date.

    Additionally, MaineCare covers up to 120 breastmilk storage bags a month while you are. Just fill out this form to get your breastmilk storage bags.

    Acelleron Helps You Get Your Breast Pump With MaineCare

    Choosing Your Pump

    With all the options out there, we know it can be overwhelming to decide what pump works best for you and your baby. That’s why we offer a FREE Pump Exploration Webinar to help make this decision easier. During this on-demand webinar, you learn about types of breast pumps, things to consider, breast pump brands, general use, and more! For a quick look at the differences between the pumps, check out our Breast Pump Comparison Grid.

    It’s As Easy As 1, 2, 3…

    Getting your breast pump covered by MaineCare has never been so easy!

    1. Select your MaineCare insurance plan and state of Maine on our form: We will verify your coverage, and if needed, obtain a prescription from your doctor.
    2. Pick your pump: Use our brand and feature filters to find the pump that will be best for you and your baby. Then, fill in the rest of the form to submit your order!
    3. Free shipping to your door: Your pump will arrive approximately 30 days prior to your due date. If you are a UHC Community Plan of NJ member, we can ship any time during your pregnancy.

    MaineCare Moms, get started now!

    The Acelleron Difference

    After you get your pump, we are still here to support you! Learn the ins and outs of your pump with a FREE Unbox Your Pump virtual consult. One of our pump experts will give you a brief overview of your pump, key features and benefits, what it comes with, how to setup and clean it, and give you some great tips & tricks!

    MaineCare expecting families can start their breastfeeding journey off on the right foot with our FREE online Breastfeeding Education Classes after you order your pump.

    Plus, have access to our Knowledge Center, Baby, Breast, and Beyond blog, and become part of our online community for support, inspiration, and exclusive access to special deals and discounts.

    Additional Maternity Support Products

    MaineCare also covers blood pressure monitors for gestational hypertension, as well as maternity support products such as a support band and compression socks, if they are medically necessary. To get your maternity support products, answer these qualifying questions.

  • Your Personal Guide to Ordering a Breast Pump Online

    Your Personal Guide to Ordering a Breast Pump Online

    Whether you are a first-time mom or one who has breastfed multiple times, we know you have countless decisions to make throughout your pregnancy. Let us make choosing and receiving your breast pump, simple and easy.

    Acelleron’s mission is to help mothers achieve their breastfeeding goals, whether that’s one month, six months, one year or more. Everyone’s journey looks different, and it can take some time to figure out what will work best for you. For many breastfeeding moms, pumping becomes a necessity at some point, whether you are going back to work, traveling, or have other children to take care of.

    We hope that by providing high-quality, top-rated breast pumps, and many cost-effective mom and baby essentials, you will be able to start this exciting journey with your new little one, with one less thing to worry about. Getting your breast pump should not be a difficult task; if anything, it should be fun and easy! Pumps are now more comfortable, quiet, efficient, and more portable than ever, making it easy to pick one to best fit your ever-changing lifestyle. Our simple online ordering tool allows you to review and select from many pump brands, based on your insurance coverage. Place your online order, and we will take care of the rest!

     

    Women on bed using computer

    Your Personal Guide to Ordering a Breast Pump Online

     

    In this guide, we will answer the most frequently asked questions when placing an online order.

    What information will you need?

    • The correct insurance information, specifically your most up-to-date primary and secondary (if applicable). We need your insurance name, and member/policy ID number listed on your insurance card. Some member/policy numbers will have a leading letter prefix, which we also need. Selecting the incorrect insurance plan online may delay the order.
    • Your date of birth is vital for verifying your insurance coverage; in most cases, we cannot verify insurance without it.
    • The best phone number to contact you.
    • Your most up-to-date address, including any Apt or Unit numbers. This information is crucial when it is time to ship your breast pump. However, if you need to change your address before we ship your pump, just contact our customer care team.
    • Your full name as it appears on your insurance card. If your last name is hyphenated, please provide both.
    • An email address is a must. This is important when trying to contact you with the status of your order. When your pump is shipped you will also receive the tracking information directly from the shipping carrier, so you can track your package.

     

    Does my insurance cover the breast pump?

    • Most insurance plans cover breast pumps for expectant or lactating mothers under the Affordable Care Act (ACA). Under the ACA, signed into law in 2010, insurance companies were required to cover preventive health services and breastfeeding equipment for pregnant and postpartum women. Coverage can vary by the insurance company and policy type. We will verify your breast pump coverage once you have placed your order.

     

    Find out what pumps your insurance covers here!

     

    Why isn’t my insurance listed?

    • The insurances in the drop-down menu are the insurances we either are in-network with or have a trusted partner to refer you to. However, if your insurance name or state of residence is not available, this is an indication that we are not in-network with that insurance and do not know a trusted provider to send you to. If you are unsure, you may contact us or call (877) 932-6327 to speak with our knowledgeable customer care team.
    • In-network provider refers to a health care provider that has a contract with the health insurance company to provide care and services to plan members for a specific allowable rate.
    • Out-of–network provider refers to a health care provider that does not have a contract with your health insurance company. Going to an out-of-network provider may result in you receiving a bill for a product or service.

     

    What is a deductible, and how do I know if I have one? 

    • Under the ACA, breast pumps are not subject to a deductible or co-insurance like other medical products or services. The deductible is the out-of-pocket responsibility of the policy holder before the insurance company will pay for medical products or services. Keep in mind, breast pump upgrades are different.
    • You should always speak with your insurance provider directly when determining whether a service is applied to your deductible.

     

    What if I have more than one insurance plan?

    • You can provide this information in the insurance fields on the order form if you are covered under more than one insurance plan. This information is crucial when verifying your eligibility and determining which plan will provide coverage for the breast pump. Not providing all insurance coverage plans at the time of your order, could result in your claim getting denied directly from your insurance provider.

    Ex: If you have commercial insurance through your employer this will always be primary to any Medicaid (state-funded) insurance coverage you may have.

     

    Do I need a prescription? What if I do no have a prescription? 

    • A prescription is needed to submit the claim to your insurance. If you do not have one before placing your order, not to worry! We can request a prescription on your behalf. You will have the option to upload a prescription with your order; your doctor may have provided this to you. Otherwise, you can enter your OBGYN or midwife’s name and office information, which we will then contact.
    • We will submit a prescription request twice to your physician’s office. Please keep in mind that we prioritize orders by delivery/due date. Once we obtain a prescription, we will call or email to confirm and finalize your order.

     

    When can I receive my pump? 

    • You may be eligible to receive your breast pump before your baby is born, but this is dependent upon your insurance plan’s guidelines. Many insurance plans allow dispensing of the pump between 1 to 4 months prior to your due date. However, some insurance and Medicaid plans require the baby to be born before receiving your breast pump. We will notify you of these specific guidelines.
    • If your insurance plan requires the baby be born before we can ship your pump, do not worry. Our shipping carrier delivers Monday through Friday and on weekends. Weekend deliveries will depend on your area.

     

    Can I return my breast pump once it has been opened? 

    • Breast Pumps are considered a personal hygiene product, and therefore, cannot be returned or exchanged if the seal on the box has been broken. The breast pumps we carry come with a warranty directly from the manufacturer. Most of the pump brands provide a one- or two-year warranty. If your product is not performing as expected, we encourage you to call the breast pump manufacturer’s customer service department for assistance.

     

    Acelleron is here for you, mama!

     

    OrderMyPump.com

  • Knowing Your Insurance Plan

    Knowing Your Insurance Plan

    At a recent visit to your doctor’s office, it was determined you may benefit from a certain type of home medical equipment (i.e. a breast pump, nebulizer, blood pressure monitor, etc.); so your physician faxed us a prescription and either provided the product directly to you, or we shipped to you! Your doctor may have explained that your insurance “covers” this product.

    Weeks later, you receive an explanation of benefits (“EOB”) from your insurance. Shortly thereafter, you receive a bill from Acelleron and you may be asking yourself:

    • Who is Acelleron?
    • What are these charges for?
    • I thought my insurance was billed for this equipment?
    • Why isn’t the equipment “covered” by my insurance?

    Do not worry! These are common questions when it comes to a commercial/private health insurance plan, and thus we want to educate you. Before we get started, here are some key terms you should understand:

    • Deductible – the amount of money the member/family must pay out-of-pocket each year before your insurance begins to pay.
    • Co-insurance – the percentage of health service cost the member/family must pay after your deductible has been met (i.e. 80%/20% means your insurance pays 80% and the member pays 20% of the product or service).
    • Co-pay – the amount due at the time of your service, per office visit.
    • Out-of-Pocket Maximum – The maximum amount of medical expenses the member/family will have to pay each year before your insurance will cover remaining expenses for that plan year.

    To calculate how close you are to reaching your out-of-pocket maximum, you would add your deductible, co-insurance payments, co-payments and then subtract that from your plan’s designated out-of-pocket maximum. Once you reach the maximum, your insurance should cover all costs.

    These key components to your insurance are typically found on the front or back of your insurance card and will help you understand why you are receiving a bill from Acelleron. And by the way, who is Acelleron? That’s easy! Acelleron was the home medical equipment provider your physician sent your order/prescription to. Physicians will typically refer their patients to home medical providers that provide high quality products and services that meet their patient’s needs.

    What does “covered” mean?

    And, what about your question about the equipment being “covered” by your insurance? Due to the rise of deductible insurance plans there has been increased confusion about what is a “covered” product or service. The truth is, “covered” now means your insurance recognizes and will pay for that product or service code, however if your plan has a deductible or co-insurance, you will be responsible for meeting those thresholds before your insurance picks up the tab.

    If you have further questions about your insurance plan, we always recommend you call your insurance member services hotline as they can help you understand the key components to your specific insurance plan. The member services phone number should be on the front or back of your insurance card.

    And while you are on the phone with member services, do not hesitate to ask a few more critical questions that will help you make better decisions when it comes using your insurance. Below are some other questions you may want to ask:

    • When can I get new equipment?
      Your specific plan may have restrictions on how often you can receive (or replace) this equipment. For example, most insurance plans cover one breast pump per pregnancy/birth. Yet, there are a few that have more restrictions, such as one breast pump every two or three years. If your insurance is the same as when you last received this equipment and the equipment no longer works, check the warranty, and if under warranty, call the manufacturer to have the device repaired or replaced. 
    • Are accessories or replacement parts covered by my insurance?
      Depending on your insurance and the specific accessory or replacement part, it may or may not be covered. Your insurance can explain if and how often these parts can be replaced so that they are covered through your insurance. For example, most health insurance plans in the northeast do not have sufficient coverage for breast pump replacement parts. If they are not covered, we suggest purchasing these products online. However, a nebulizer cup and tubing kit is typically covered one every six months.
    • Are breast pumps free through my insurance?
      Usually, but there are exceptions. Under the Affordable Care Act (“ACA”), health insurance companies must cover a breast pump with no out-of-pocket costs. While most plans follow the ACA and will allow one (1) breast pump per pregnancy, there are instances where the ACA is not followed (specifically grandfathered plans and individuals under age 26 covered under a parent plan.)  Knowing your plan guidelines for receiving/accepting a breast pump is important.

    Written by Cheryl Fillmore, Director of Revenue Cycle at Acelleron.

  • Aetna changes breast pump policy for the better!

    Aetna changes breast pump policy for the better!

    Being an Aetna in-network breast pump provider, Acelleron is excited to learn that Aetna has revised their Breast Pump Clinical Policy Bulletin to state that a “replacement standard electrical breast pump is considered medically necessary for each subsequent pregnancy, for initiation or continuation of breastfeeding during pregnancy or following delivery.”

    Previously, Aetna only covered one breast pump every three years since the Affordable Care Act went into effect back in 2013. This brings Aetna’s coverage in line with most of the insurance companies we work with.

    • Aetna considers “a manual or standard electric breast pump medically necessary during pregnancy or at any time following delivery for breastfeeding.”
    • Aetna considers “a manual or standard electric breast pump medically necessary for women who plan to breastfeed an adopted infant when the above listed criteria are met.”

    If you qualify for a replacement breast pump through Aetna, click here to submit your order.

    It is also important to understand that some Aetna plans do not follow the Affordable Care Act requirements for coverage of breast pumps. This includes grandfathered plans, or otherwise exempt plans. Employers with grandfathered plans may choose not to cover breast pumps, or include cost share (deductible, copay or coinsurance).

    Lastly, Aetna’s policy on breast pump replacement supplies remains the same: “for comfort and convenience (replacement polycarbonate bottle; replacement cap, nipple or lid for breast pump bottle; and replacement locking ring) are not covered.”

    Order your breast pump today!

    About Aetna and CVS Health

    Founded in 1853 in Hartford, CT, Aetna is one our nations’ largest commercial and Medicaid health insurance providers for individuals, employers, health care professionals, and producers. Aetna is now a subsidiary company of CVS Health Corporation.

    CVS Health is the nation’s premier health innovation company helping people on their path to better health. Whether in one of its pharmacies or through its health services and plans, CVS Health is pioneering a bold new approach to total health by making quality care more affordable, accessible, simple and seamless.