A Guide to Breastfeeding Supplies for Today’s DME
“Breastfeeding comprehensive support and counseling from trained providers, as well as access to breastfeeding supplies, for pregnant and nursing moms… Coverage of comprehensive lactation support and counseling and costs of renting or purchasing breastfeeding equipment extends for the duration of breastfeeding. Nonetheless, consistent with PHS Act section 2713 and its implementing regulations, plans and issuers may use reasonable medical management techniques to determine the frequency, method, treatment, or setting for a recommended preventive item or service, to the extent not specified in the recommendation or guideline.”
Insurance plans must cover the cost of a breast pump, but health plans cover only what is deemed “medically necessary.” What are the implications for Durable Medical Equipment (DME) companies?
Shrinking Reimbursements and Lower Fertility Rates
While initially, the coverage of breastfeeding supplies was a boost for DME companies, insurance companies have paid lower reimbursement rates in recent years. Before April 2018, one major insurance payer paid $169.15 for a double electric breast pump. They have since cut its reimbursement rate for a breast pump to $95. Coupled with the lowering fertility rates and millennials waiting longer to start families, the potential revenue for a double electric breast pump is trending down. A DME provider has two options- lower costs or increase billable items. With Motif Medical, a DME can do both.
The Motif Luna – More Milk in Less Time ®
The Motif Luna is our desktop breast pump. The Luna is specifically designed for the insurance payer.
The Motif Luna was designed to meet the performance IBCLCs want and includes the features moms have been asking for in a breast pump.
While developing the Luna, we asked what mom needs from her breast pump. She overwhelmingly (~83% of moms surveyed) responded that suction strength was “very important.” The Motif Luna has been shown to pump more milk in less time in our latest research.
Market share at one DME increased by 10% over a six month period after introduction of the Luna.
Motif Medical has two additional pumps – the Duo and the Twist. The Motif Duo is a lightweight, portable pump with a lithium-ion battery. The Motif Twist is a convenient, economical breast pump. Regardless of a mom’s needs or her insurance coverage, Motif Medical has a breast pump that can fit her needs.
Continued Support Covered by Insurance
The American Academy of Pediatrics recommends that infants be exclusively breastfed for the first six months with continued breastfeeding while introducing appropriate complementary foods for one year or longer.
The majority of women do not stay at home with their children for six months. So if a mom’s goal is to provide breast milk for that long, she’ll need to pump. Worn out breast pump parts are one of the leading causes of lower milk supply.
That’s why most insurance companies will cover replacement parts. Depending on the insurance plan, a mom can receive new breast pump supplies like tubing, duck valves, backflow protectors, and breast shields. Generally, a DME can bill every 90 days for new supplies.
Additional Billable Products – Maternity Compression
Maternity compression garments are FDA-listed medical devices designed by experts to provide support, relief, and stabilization for increased comfort during pregnancy and postpartum. Maternity compression garments include pregnancy support bands, postpartum recovery garments, and gradient compression socks.
Pregnancy support bands work by relieving pregnancy-related pressure from the abdomen, hips, and lower back to reinforce the body’s core. The band’s simple redistribution of weight provides incredible relief and comfort during everyday activities.
Postpartum recovery support garments work by providing structure to stabilize the stomach, back, and hips after birth. The C-Section garment also includes a side-zipper designed for easy wear after a C-Section and aids in wound healing.
Compression socks or maternity socks help circulate blood, reduce swelling, and relieve pain and cramping during all stages of pregnancy and postpartum.
This product line is a durable medical benefit so deductibles and coinsurance do factor into it. Coverage for patients is subject to all terms and conditions of the applicable benefit plan, including specific exclusions and limitations, and to applicable state and/or federal law.
Need help understanding how to bill for maternity compression?
Breast Pump Accessories Moms Need
While insurance companies determine what is “medically necessary,” that doesn’t necessarily mean mom has everything she needs.
Motif offers a full spectrum of products, helping mom decrease the number of suppliers needed to fully support her pregnancy journey. We have options to create kits and bundles that will help you stand out to moms, differentiating you as a supplier that goes above and beyond.
Partnering with Motif Medical
We want to build a partnership with durable medical equipment suppliers. Our goal is to help grow awareness and drive insurance leads. Increase the lifecycle of your customers with a full collection of insurance-eligible and cash pay accessories. All the way from pregnancy to postpartum.
Become part of Motif’s referral network. Customers will be directed to your website through our insurance lookup tool.
You will receive a marketing kit with images, descriptions, social graphics, user guides, plus product and lifestyle images. We will work with you on developing co-marketing opportunities.
With lactation and postpartum professionals on staff, customers can connect with the support they need at any time.
We’ll train your staff and give them the tools they need to become Motif product specialists.
Competitive for the insurance market, we know the tools, support, and products you need to be successful.
Full Product Line
We increase the lifecycle of your customer with a full collection of insurance-eligible products all the way from pregnancy to postpartum.
Increase the lifecycle of your customers with a full collection of insurance-eligible and cash pay accessories. All the way from pregnancy to postpartum.
All content published on the Motif Medical site is credited for information purposes only. This information should not substitute as medical advice, diagnosis, or treatment. Always consult your doctor or qualified health professional with any questions regarding the health of you or your baby.