Breastfeeding Insurance Reimbursement - Tax Benefits You Should Know About

Have you taken advantage of the new tax benefits for breastpumps and supplies yet? If not, here’s what you should know about potential cost savings.

In February 2011, the IRS reversed its previous ruling, which denied breastfeeding-related supplies from being covered as a health expense. The decision to include it as an allowable health expense is a major milestone for nursing moms, as breastpumps and supplies that assist breastfeeding are now considered “medical care” and tax deductible. This means that moms and families can now use their pre-tax dollars from their flexible spending accounts (FSA) and health savings accounts (HSA) to cover the cost of lactation supplies.

For clarification, here is a brief explanation of these accounts:

Health flexible spending account (FSA): a type of tax-advantaged financial account that can be set up through an employer in the United States. An FSA allows an employee to set aside a portion of her pre-tax earnings to pay for qualified medical expenses as established in the plan.

Health savings account (HSA): a tax-advantaged medical savings account available to taxpayers who are enrolled in a high deductible health plan (HDHP).

Here is what you should know:
•The IRS guidance is broadly interpreted and covers any supplies that “assist lactation.”
•FSA/HSA benefits providers may differ slightly in what they may cover. For example, some may define a breastpump as an allowable expense, but not other supplies.
•It is important for you to contact your employer’s benefits provider to determine what is covered under your specific FSA/HSA and the steps needed for reimbursement.
•If you do not have a FSA/HSA account, you may be able to deduct breastfeeding costs if your total unreimbursed medical expenses exceed 7.5 percent of your adjusted gross income, and if you itemize your tax returns.

FSA/HSA plans are one of two ways you can explore reimbursement for your breastpump. Private insurance may also offer coverage.

Could my breastpump or lactation services be covered by my insurance?

Many health insurance plans are aware of the numerous health benefits of breastfeeding and therefore may cover certain breastfeeding-related expenses, including for example, lactation consultant services, breastpump rental/purchase and other costs. Coverage for breastfeeding-related expenses will vary widely among different health insurance plans.

Medela worked with respected insurance experts to provide you with several reimbursement-related resources that may help you in getting coverage for your breastfeeding-related expenses. The materials here can be used by expectant and new parents to help in submitting claims as well as appealing denied claims for services. There are also additional templates that can help you get assistance from your employer, healthcare provider and lactation consultant.

Take time to review each information category. Reading the information in the order in which it is outlined will help. Each information page is available in PDF format for you to download at your convenience.

•Coverage Questions You Should Ask
•Tips for Communicating with Your Insurance Company
•Understanding the Benefits of Breastmilk
•Filing an Insurance Claim
•Lactation Consultant Coverage
•Appealing an Insurance Claim
•Quick Reference Guide - Coding

Please note: in addition to private insurance assistance, some other state and federal programs may offer breastfeeding support and reimbursement under certain circumstances. For more information call your local Women’s Infants and Children (WIC) office or your local state Medicaid office.

For more information you may also visit http://www.aap.org/breastfeeding/files/pdf/CODING.pdf