If you have health insurance through a plan that was active before the Affordable Care Act (ACA) passed in 2010, you may be enrolled in what's called a “legacy plan.” These older plans are exempt from certain ACA requirements, including the rule that insurance must fully cover specific preventive services.
Under the ACA, breast pumps and breastfeeding support are classified as preventive services, meaning most insurance plans must cover them without any out-of-pocket costs. However, legacy plans don’t have to follow this rule—so your insurer may still apply a deductible, copay, or other cost-sharing for a breast pump.
Coverage can vary widely between legacy plans and insurers. If you're unsure about what's included in your benefits—especially when it comes to breast pump coverage—it’s a good idea to reach out to your insurance provider or your employer’s HR department for clarification.
At Babylist Health, we understand how complicated insurance can be. We’re here to help make things a little easier by breaking down what’s covered and what to expect.