Mothers who are looking to use Tricare's newly mandated breastfeeding supplies and support coverage will have to wait an unknown amount of time to find out exactly what the military healthcare insurer will be covering, officials said.
"Until the policy has been developed to address what Tricare 'will and will not' provide under this benefit, and it has been approved, these services and supplies are still not covered," said Kevin Dwyer, a Tricare spokesman. "Beneficiaries should save receipts for supplies purchased in case they can be reimbursed once the policy is approved."
The mandate, included in the 2015 National Defense Authorization Act, requires Tricare to provide "breastfeeding support, supplies (including breast pumps and associated equipment), and counseling ... as appropriate during pregnancy and the postpartum period."
But, like the Affordable Care Act, which the measure was designed to mirror, the rule leaves some things open to the individual company's coverage policy. For example, some insurers choose to cover manual breast pumps, while others will pay for hospital-grade electric pumps.
If a woman plans to use the pump to allow her to hold a job away from her infant while exclusively breastfeeding, an electric pump is far preferred and can be a lynchpin issue on whether or not working moms can breastfeed their babies. The cost difference, however, can be several hundred dollars.
The American Academy of Pediatrics (AAP) recommends that babies be exclusively fed breast milk until six months old.
"Given the documented short- and long-term medical and neurodevelopmental advantages of breastfeeding, infant nutrition should be considered a public health issue and not only a lifestyle choice," the AAP says in their breastfeeding policy statement.
Under current policy, Tricare covers "hospital grade breast pumps for premature infants who meet certain criteria." Some Tricare users may have access to lactation consultants through their local military treatment facility (MTF) or during their hospital stay after giving birth. The policy, however, does not address other consultants.
Receipts for supplies and support purchased after Dec. 2 can be submitted to Tricare after the new rules are released. However, reimbursement is not guaranteed.
Officials said they have no estimate on when the new policy will be issued.
-- Amy Bushatz can be reached at firstname.lastname@example.org