TRICARE-Covered Breast Pumps

FAQs About the TRICARE-Covered Breast Pump Program

As a mother-to-be, 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.

You can get a breast pump from any:

• Network or durable medical equipment provider

• Commissary (run by the Defense Commissary Agency)

• Post Exchange (PX), Base Exchange (BX), or Station Exchange run by:

  • The Army/Air Force Exchange Service (AAFES);

  • The Department of the Navy;

  • The U.S. Marine Corps; or

  • The U.S. Coast Guard

• Civilian stateside and overseas retail stores

• Online store (standard shipping and handling is covered)

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 and your regional contractor to get a referral and 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 pump

• If you don’t want to pay up front, contact your regional contractor to find a network provider or supplier. You need to show your prescription.

• If you are working with a military clinic or hospital to get a breast pump, follow their processes and procedures.

• If you don’t mind paying up front, go to a TRICARE-authorized provider, supplier, or vendor (includes retail and online stores). Make sure to save and copy your receipt. You won’t need to show your prescription.

Step 3: File a claim

• If you use a network provider or supplier, you don’t have to file a claim.

• If you bought the pump yourself, file a claim:

  • Complete a DD Form 2642

  • Attach a copy of the prescription and receipt

  • Mail it to your TRICARE claims processor and your regional contractor will mail you a check.

No, coverage isn’t limited to a specific manufacturer, brand, or model number. Contact your regional contractor for more information.

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

Note: Overseas limits are different due to changes in currency rates, availability, and shipping costs

TRICARE covers:

• One breast pump kit per birth event. The kit may not be separately billed for and reimbursed.

• Standard power adapters: 1 replacement per birth event, and not within 12 months of the breast pump purchase date.

• Tubing and tubing adapters: 1 set per birth event.

• Locking rings: 2 every 12 months

• Bottles: 2 replacement bottles and caps/locking rings every 12 months following the birth event

• Bottle caps: 2 every 12 months after the birth event

• Storage bags: 90 bags every 30 days following the birth event

• Valves/membranes: 12 for each 12 months following the birth event

• Supplemental Nursing System (SNS): 1 per birth event when a physician prescribes

• Nipple shields/splash protectors: 2 sets (2 shields/set) per birth event when a physician prescribes

You can receive supplies in excess of the limits above when your provider prescribes them and when medically necessary. 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

Yes. TRICARE covers up to 6 individual outpatient breastfeeding counseling sessions per birth event when:

• Your provider bills using one of the preventive counseling procedure codes;

• Breastfeeding counseling is the only service you get during the session; and

• You see a TRICARE-authorized provider

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

If you saw a:

• Network provider, ask the provider to file a claim for you using one of the preventive counseling procedure codes.

• Non-network provider, fill out a DD Form 2642, attach an itemized statement that includes one of the preventive counseling procedure codes, and mail it to your TRICARE claims processor.

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