Denver Health Medical Plan (DHMP) Breast Pump Benefits

Breastfeeding plays a protective role in the health of both babies and moms. It can give your baby health benefits that may last a lifetime. Pregnant or postpartum members of all DHMP plans are entitled to receive a breast pump as a benefit of your health insurance coverage. 

Pregnant or postpartum members of Denver Health Medical Plan, Inc. (DHMP) Elevate Health Plans (Exchange and CO Option) and DHHA Employer Group plans are entitled to receive a breast pump as a benefit of your health insurance coverage. The breast pump allowance is $150 per pregnancy and will cover a standard model. If you select a breast pump with a higher value than the allowance, then you will pay the cost difference directly to the vendor.

To get a breast pump: 

  • You must be at or beyond 28 weeks of pregnancy.
  • Your doctor must submit a breast pump order for you.
  • Pick up your breast pump at one of our preferred providers, Rocky Mountain Medical Supply (Adapthealth) or Bili Blanket, or have it shipped directly to you.
  • The preferred providers will bill your health insurance directly.
  • Your doctor must fax a breast pump order directly to one of the following vendors.
     
    • Rocky Mountain Medical Supply, now Adapthealth
      Tel: 303-806-8001
      Fax: 303-806-8030
      Standard model name and brand: Medela item #101035077 
      Double Electric Breast Pump Starter Kit, In Style Advanced
       
    • Bili Blanket Baby
      Tel: 877-593-2454
      Fax: 800-231-0352
      Bili Blanket Baby Order Form


Commercial Plans Breast Pump Flyer

Breast pumps are a covered benefit for all Colorado Medicaid enrollees. Both manual and double-electric breastfeeding pumps are now covered as early as 28 weeks into pregnancy or at any time during the postpartum period.

A prior authorization is NOT REQUIRED when:

A prior authorization IS REQUIRED when:

  • Vendor is not a Preferred Vendor
  • Breast pump is over $500
  • Rented (RR) modifier

To get a breast pump:

  • You must be at or beyond 28 weeks of pregnancy or at any time during the postpartum period
  • Your doctor must submit an order for the breast pump directly to vendor

Breast pumps are a covered benefit for all Colorado CHP+ enrollees. Both manual and double-electric breastfeeding pumps are now covered as early as 28 weeks into pregnancy or at any time during the postpartum period.

A prior authorization IS REQUIRED for:

  • All requests, as CHP+ currently has no Preferred Vendors
  • Breast pumps over $500
  • Rented (RR) modifier

To get a breast pump:

  • You must be at or beyond 28 weeks of pregnancy or at any time during the postpartum period
  • Your doctor must submit an order for the breast pump directly to vendor

Breast pumps are a covered benefit for all Medicare enrollees. Both manual and double-electric breastfeeding pumps are now covered as early as 28 weeks into pregnancy or at any time during the postpartum period.

A prior authorization is NOT REQUIRED when:

  • Ordered through the following Preferred Vendors
    Shield Healthcare (Phone: 866-304-7160,  Fax: 469-443-9701)
    Edgepark Medical Supplies (Phone: 888-394-5375, Fax: 303-405-6842)
  • Breast pump is under $500
  • Purchased (NU) modifier

A prior authorization IS REQUIRED when:

  • Vendor is not a Preferred Vendor
  • Breast pump is over $500
  • Rented (RR) modifier

To get a breast pump:

  • You must be at or beyond 28 weeks of Pregnancy or at any time during the postpartum period
  • Your doctor must submit an order for the breast pump directly to vendor

Benefit Questions? Email Health Plan Services for answers to your benefit questions, or contact us by phone.