Table 2.

Select elements of the breastfeeding support, supplies, and counseling provision provided through the ACA for both non-grandfathered plans and Medicaid coverage through Alternative Benefit Plans (includes coverage of individuals enrolled through the ACA’s Medicaid expansion)

What is covered at no cost sharing?	Requirements for coverage	Within discretion of each insurer
Breastfeeding education and lactation consultation provided in-network	Available both before and after birth and for duration of breastfeeding If such services are not available within the insurer’s network, out-of-network services must be provided with no cost sharing	Subject to reasonable medical management to determine frequency, method, treatment, or setting Reimbursement policy is outside the scope of the HRSA Guidelines and regulations
Breast pump	Available for duration of breastfeeding and in conjunction with each birth; “Over the counter” items and services recommended under the preventive services provision must be provided without cost sharing as long as prescribed by a health care provider.	Subject to reasonable medical management to determine frequency, method, treatment, or setting Type of pump covered* Whether pump is rented or purchased Whether provider pre-authorization or prescription is required Whether provided before or after birth
Breast pump supplies	Available for duration of breastfeeding and in conjunction with each birth Note: The specific supplies required to be covered are not stated	Subject to reasonable medical management to determine frequency, method, treatment, or setting
* “Over-the-counter” products, such as breast pumps, recommended under the preventive services provision must be covered without cost-sharing when prescribed by a health care provider

Abbreviation: ACA, Patient Protection and Affordable Care Act; HRSA, Health Resources and Services Administration

Data from United States Department of Labor. FAQS about affordable care act implementation part XII. Available at: http://www.dol.gov/ebsa/faqs/faq-aca12.html. Accessed February 5, 2015