Breast Pumps for Mothers of Newborns

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:

• Ordered through the following Preferred Vendors
  Shield Healthcare (Tel: 866-304-7160, Fax: 469-443-9701)
  Byram Healthcare (Tel: 800-873-8385, Fax: 303-935-0718)
  Edgepark Medical Supplies (Tel: 888-394-5375, Fax: 303-405-6842)
  Bili Blanket Baby (Tel: 877-593-2454, Fax: 800-231-0352, Bili Blanket Baby Order Form)
• 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

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