Breast Pumps and Supplies Frequently Asked Questions

All USFHP-eligible members 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. You can get these items before or after delivery.

You can get a breast pump from any:

• Network or medical equipment provider
• Retail stores
• Online store (standard shipping and handling is covered)

No, there isn’t a specific list. USFHP pays up to a set amount for a breast pump and initial breast pump kit. Rates are set by TRICARE and may change annually. You can find the rates at health.mil.

Step 1: Get a prescription

• Your prescription must be from a TRICARE-authorized doctor, physician assistant, nurse practitioner or nurse midwife.
• Your prescription must show if you’re getting a basic manual or standard electric pump. To get a hospital-grade pump, you need to work with your provider to get authorization.
• Your prescription doesn’t have to specify a brand.
• If you’re going to get your breast pump from a network provider or durable medical equipment supplier, ask your provider to include a diagnosis code on your prescription.
• We suggest you make a copy of your prescription for your records.

Step 2: Get a breast pump

• If you don’t want to pay up front for the breast pump at the time of purchase, use a network provider or durable medical equipment supplier. You will need to show your prescription.
• If you don’t mind paying up front, purchase your breast pump from a vendor (includes retail and online stores). Make sure to save and copy your receipt. You will need to show your prescription.

Step 3: Submit a request for medical reimbursement

• If you purchased your breast pump from a network provider or durable medical equipment supplier, you don’t have to file a request for medical reimbursement.
• If you bought the pump yourself, submit a request for medical reimbursement.
• Download the form here or go to “I’m a Member” and select “Plan Documents” from the drop-down menu.
• Attach a copy of the prescription and receipt.
• Mail to the address on the form.

Step 1: Find your receipt

• You must have been eligible for USFHP on the date you made the purchase.
• If you can’t find your receipt or you weren’t eligible when you bought it, you cannot get reimbursed.

Step 2: Get a prescription

• You must get your prescription from a TRICARE-authorized doctor, physician assistant, nurse practitioner or nurse midwife.
• Your prescription must show the type of pump you bought (manual or standard electric pump).
• Your prescription doesn’t have to specify a brand.
• We suggest you make a copy of your prescription for your records.

Step 3: Submit a request for medical reimbursement

• If you purchased your breast pump from a network provider or durable medical equipment supplier, you don’t have to file a request for medical reimbursement.
• If you bought the pump yourself, submit a request for medical reimbursement.
• Download the form here or go to “I’m a Member” on the USFHP home page and select “Plan Documents” from the drop-down menu.
• Attach a copy of the prescription and receipt.
• Mail to the address on the form.

Yes.

No. Coverage isn’t limited to a specific manufacturer, brand or model number. Breast pumps with “luxury or deluxe” features, such as smartphone connectivity, Bluetooth connectivity, enhanced/expanded rechargeable batteries, or unnecessary accessories, such as luxury tote bags, car adapters, or nipples for use with bottle feeding are excluded. Beneficiaries may elect to purchase luxury or deluxe pumps and pay for the difference between TRICARE’s maximum benefit and the actual cost of the pump.

USFHP covers:

• One breast pump kit per birth event. Kits are specific to each manufacturer and provide necessary supplies. The supplies included in the kits may not be separately billed for and reimbursed.
• Standard power adapters: One replacement per birth event and not within 12 months of the breast pump purchase date.
• Tubing and tubing adapters: One set per birth event.
• Locking rings: Two every 12 months.
• Bottles: Two replacement bottles and caps/locking rings every 12 months following the birth event.
• Bottle caps: Two every 12 months after the birth event.
• Storage bags: 100 bags every 30 days following the birth event.
• Valves/membranes: 12 for each 12 months following the birth event.
• Supplemental nursing system (SNS): One per birth event when a physician prescribes.
• Nipple shields/splash protectors: Two sets (two shields/set) per birth event when a physician prescribes.

You can receive supplies in excess of the limits above when medically necessary and your provider prescribes them. You need to get new prescriptions when you need replacement supplies that exceed the above limits. Your provider needs to be specific about what supplies you need.

TRICARE doesn’t cover (unless part of a breast pump kit):

• 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

You can get breast pump supplies from any:

• Network provider or durable medical equipment supplier
• Retail stores
• Online store (standard shipping and handling is covered)

As an expectant mother, you can get breast pump supplies before delivery, starting at 27 weeks, or up to 3 years after the birth event. The 3-year period starts on the child’s birth date or the date of the legal adoption. A birth event includes a pregnant beneficiary or a female beneficiary who legally adopts an infant and intends to personally breastfeed.

Step 1: Get supplies

• If you don’t want to pay up front for breast pump supplies at the time of purchase, use a network provider or durable medical equipment supplier.
• If you don’t mind paying up front, purchase from a vendor (includes retail and online stores). Make sure to save and copy your receipt.

Step 2: Submit a request for medical reimbursement

• If you purchased your breast pump supplies from a network provider or durable medical equipment supplier, you don’t have to file a request for medical reimbursement.
• If you bought the pump yourself, submit a request for medical reimbursement.
• Download the form here or go to “I’m a Member” and select “Plan Documents” from the drop-down menu.
• Attach a copy of the prescription and receipt.
• Mail to the address on the form.

Yes. USFHP covers up to six individual outpatient breastfeeding counseling sessions per birth event when the following requirements are met:

• Your provider bills using one of the preventive counseling procedure codes
• Breastfeeding counseling is the only service you get during the session
• You see a TRICARE-authorized provider

These sessions are in addition to the counseling you may have received during your inpatient stay, outpatient OB visit or well-child care visit.

No, unless they’re also a TRICARE-authorized doctor, physician assistant, nurse practitioner, nurse midwife or registered nurse.

Sign up for our free two-hour online workshop, Baby Basics, perfect for expecting and new parents on caring for their newborn from birth to 6 months of age. Along with holding and feeding, you will learn things like skin care, healthy sleep and noticing warning signs. Our professional health educators give you solid advice on baby care and show you the best methods for things like feeding, diaper changing, bathing your baby and umbilical care. Along with practical tips on caring for your baby, there is also valuable advice on how to take care of yourself so you can better care for your baby.

Yes, under certain conditions. Contact Customer Service for help.

Yes. For breast pump limits set by TRICARE, see the table at health.mil.

Yes. USFHP covers one breast pump per birth event. A birth event includes a pregnant beneficiary or a female beneficiary who legally adopts an infant and intends to personally breastfeed. You can get these items before or after delivery.

No, USFHP doesn’t cover extended warranties.