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View TRICARE's Breast Pumps and Materials Often Asked Concerns page for in-depth benefit info. Submitting Claims Network suppliers need to send claims for TRICARE recipients. Beneficiaries who purchase breast pumps/supplies from non-network providers, civilian shops or retail drug stores can send claims to HNFS for reimbursement. A copy of the prescription need to be consisted of with the claim.


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Visit our Submit a Recipient Claim page for information on how to submit claims. Copayments and Cost-Shares Copayments, cost-shares and deductibles are not used to breast pumps, materials and breastfeeding therapy. Reimbursement Rates Compensation rates can be seen at under the Resilient Medical Devices, Prosthetics, Orthotics, and Materials (DMEPOS) pricing.

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Banked Donor Milk Banked donor milk is a limited TRICARE benefit when clinically necessary. Protection includes approximately 35 ounces each day per baby. The donor milk need to come from a milk bank certified by the Human Milk Banking Association of North America (HMBANA). See TRICARE's Covered Providers page to read more about coverage restrictions and requirements.

Nevertheless, all recipients should get a prescription from the doctor actively managing their/their baby's treatment. The preliminary prescription is legitimate for 30 days. Protection might be extended in 30-day periods through 12 months of age, when medically needed and with a brand-new prescription. Sending Also Found Here If the HMBANA-accredited milk bank sues in your place, it must include a copy of the prescription and supporting medical documentation (readily available from the prescribing supplier) with the claim.

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A copy of the prescription should be included with the claim. Visit our Send a Recipient Claim page for details on how to send claims.

Policy Aetna considers leasing of a recyclable breast pump medically necessary long lasting medical equipment (DME) when either of the following criteria is satisfied: For the period of time that a newborn is apprehended in the hospital after the mother is discharged; breast pump leasing is not thought about clinically needed once the newborn is released; or For children who have genetic conditions that interfere with feeding, a breast pump is considered medically required for up to 12 months of age.