Who can get a manual or standard electric breast pump, supplies, and breastfeeding counseling services?
All TRICARE-eligible female beneficiaries with a “birth event.” A birth event includes a pregnant beneficiary or a female beneficiary who legally adopts an infant and intends to personally breastfeed.
It doesn’t matter what TRICARE plan you use (TRICARE Prime, TRICARE Standard, USFHP, TRICARE Reserve Select, etc.) or your sponsor’s status (active duty, retired, Guard/Reserve).
Where can I get a breast pump?
You can get a breast pump from any:
- Provider or supplies that accepts TRICARE
- Commissary
- Post Exchange (PX)
- Civilian stateside and overseas retail stores (such as Walmart, Target, Babies”R”Us)
- Civilian stateside and overseas retail drug stores (not available through TRICARE Pharmacy Home Delivery)
- Online store (such as Amazon.com; shipping and handling not included)
Is there a list of approved providers I can buy a breast pump from?
No, there isn’t a specific list. Call UnitedHealthcare Military West (877) 988-9378 for help finding an approved provider.
How do I get a breast pump?
- Get a prescription.
- Your prescription must be from any TRICARE-authorized doctor, physician assistant, nurse practitioner, or nurse midwife.
- Your prescription must show if you’re getting a manual or standard electric To get a hospital-grade pump, you need to work with your provider and regional contractor to get a referral and authorization.
- Your breast pump and supplies can be on the same prescription.
- Your prescription doesn’t have to specify a brand.
- We suggest you make a copy of your prescription for your
- Get a pump.
- If you don’t want to pay up front, contact UnitedHealthcare Military West (877) 988-9378 to find a network provider. You give the provider your prescription.
- If you want to get your pump from a military clinic or hospital, follow their processes and procedures.
- If you don’t mind paying up front, go to a TRICARE-authorized provider, supplier, or vendor and make sure to save and copy your receipt. You won’t need to show your prescription.
- File a claim.
- If you use a network provider, the provider files your claim.
- If you bought the pump yourself, you have to fill out a DD Form 2642, attach a copy of the prescription and itemized receipt, and mail it to TRICARE West Region Claims Department, P.O. BOX 7064, Camden, SC 29021-7064.
- It may take up to 60 days to process your claim.
- Check your Explanation of Benefits (mail or online).
I bought a breast pump. How do I get reimbursed?
- Find your receipt.
- Your receipt has to show you bought the pump on or after Dec. 19, 2014.
- You must have been TRICARE eligible on the date you bought it.
- If you can’t find your receipt, you bought the pump before December 19, 2014, or you weren’t eligible when you bought it, you cannot get reimbursed.
- Get a prescription.
- You must get your prescription from any TRICARE-authorized doctor, physician assistant, nurse practitioner, or nurse midwife, even if you already bought a pump.
- The date on the prescription can be after the date on your receipt.
- Your prescription must show the type of pump you bought (manual or standard electric pump).
- Your breast pump and supplies can be on the same prescription.
- Your prescription doesn’t have to specify a brand.
- We suggest you make a copy of your prescription for your records.
- File a claim.
- You have to fill out a DD Form 2642, attach a copy of your prescription and receipt, and mail it to TRICARE West Region Claims Department, P.O. BOX 7064, Camden, SC 29021-7064.
- It may take up to 60 days to process your claim.
- Check your Explanation of Benefits (mail or online).
I’m no longer TRICARE eligible, but bought a breast pump when I was eligible. Can I still file a claim?
Yes, as long as your receipt shows you bought the pump on or after December 19, 2014.
Is there a list of approved breast pumps and supplies?
No, there isn’t a specific list.
What breast pump supplies are covered?
Your supplies must match the type of pump on your prescription. TRICARE covers:
- Standard power adapters
- Tubing and tubing adaptors
- Locking rings
- Bottles
- Bottle caps
- Shield/splash protectors
- Storage bags
- Up to 2 breast pump kits per birth event
TRICARE does not cover:
- Breast pump batteries, battery-powered adapters, and battery packs
- Regular “baby bottles” (bottles not specific to pump operation), including associated nipples, caps, and lids
- Travel bags and other similar carrying accessories
- Breast pump cleaning supplies
- Baby weight scales
- Garments and other products that allow hands-free pump operation
- Ice packs, labels, labeling lids, and other similar products
- Nursing bras, bra pads, breast shells, and other similar products
- Over-the-counter creams, ointments, and other products that relieve breastfeeding related symptoms or conditions of the breasts or nipples
Where can I get breast pump supplies?
You can get breast pump supplies from any:
- Firm, supplier, or provider that accepts TRICARE
- Commissary
- Post Exchange (PX)
- Civilian stateside and overseas retail stores (such as Walmart, Target, Babies”R”Us)
- Civilian stateside and overseas retail drug stores (not available through TRICARE Pharmacy Home Delivery)
- Online store (such as Amazon.com; shipping and handling not included)
When can I get breast pump supplies?
As a mother-to-be, you can get breast pump supplies before or up to 3 years (36 months) after the “birth event.” A birth event includes a pregnant beneficiary or a female beneficiary who legally adopts an infant and intends to personally breastfeed.
How do I get TRICARE to cover breast pump supplies?
- Get supplies.
- If you don’t want to pay up front, contact UnitedHealthcare Military West (877) 988-9378 to find a network provider.
- If you want to get your supplies from a military clinic or hospital, follow their processes and procedures.
- If you don’t mind paying up front, go to a TRICARE-authorized provider, supplier, or vendor and make sure to save and copy your receipt.
- File a claim.
- If you use a network provider, the provider files your
- If you bought the supplies yourself, fill out a DD Form 2642, attach a copy of the receipt, a copy of your breast pump prescription, and mail it to TRICARE West Region Claims Department, P.O. BOX 7064, Camden, SC 29021-7064.
- It may take up to 60 days to process your
- Check your Explanation of Benefits (mail or online).
Does TRICARE cover breastfeeding (lactation) counseling?
Yes, you may get up to 6 individual outpatient breastfeeding/lactation counseling sessions, per birth event when:
- Your provider bills using one of the preventive counseling procedure codes;
- Breastfeeding/lactation counseling is the only service you get; and
- You see a TRICARE-authorized provider
These sessions are in addition to the counseling you may have gotten during your inpatient stay, outpatient OB visit, or well-child care visit.
You don’t need a referral or authorization for breastfeeding/lactation counseling.
Can I get reimbursed for breastfeeding counseling (lactation counseling) that I got on or after December 19, 2014?
Yes, as long as:
- Your provider bills using one of the preventive counseling procedure codes;
- Breastfeeding/lactation counseling is the only service you get; and
- The provider is TRICARE-authorized.
How do I get reimbursed for breastfeeding counseling?
If you saw a:
- Network provider, ask the provider to file a claim for you.
- Non-network provider, fill out a DD Form 2642, attach an itemized statement, and mail it to TRICARE West Region Claims Department, P.O. BOX 7064, Camden, SC 29021-7064.
- It may take up to 60 days to process your claim
Does TRICARE cover breastfeeding counseling from an Independent Board-Certified Lactation Consultant (IBCLC) or Certified Lactation Counselor (CLC)?
No, unless they’re also a TRICARE-authorized doctor, physician assistant, nurse practitioner, nurse midwife, or registered nurse.
Can I get reimbursed for a rented hospital-grade breast pump I returned?
Yes, as long as you meet medical necessity. To file a claim, fill out a DD Form 2642, attach copies of your prescription, itemized billing statement, and documentation of medical necessity from your provider, and mail it to your TRICARE West Region Claims Department, P.O. BOX 7064, Camden, SC 29021-7064. It may take up to 60 days to process your claim.
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