Last week, TRICARE eligibility was incorrectly removed from around 25K Army Active Guard and Reserve personnel records. All AGR records and TRICARE health plans should be corrected and reinstated by 1/28. Many will need new primary care assignments. The TRICARE regional contractorsare working to complete those assignments as soon as possible. We apologize for the inconvenience.
TRICARE covers breast pumps, breast pump supplies, and breastfeeding counseling at no cost for new mothers, including mothers who adopt an infant and plan to breastfeed.
Please review the following questions and answers for more information.
All TRICARE-eligible female beneficiaries with a birth event. A birth event includes a pregnant beneficiary or a female beneficiary who legally adopts an infant and intends to personally breastfeed. You can get these items before or after delivery.
It doesn’t matter what TRICARE plan you use (TRICARE Prime, TRICARE Select, the US Family Health Plan, TRICARE Reserve Select, etc.) or your sponsor’s status (active duty, retired, Guard/Reserve).
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.
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.
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
Post Exchange (PX), Base Exchange (BX), or Station Exchange run by the:
The Army/Air Force Exchange Service (AAFES);
The Department of the Navy;
The United States Marine Corps; or
The United States Coast Guard
Civilian stateside and overseas retail stores
Online store (Standard shipping and handling is covered.)
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.
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.
Yes, TRICARE covers one breast pump per birth event. A birth event includes a pregnant beneficiary or a female beneficiary who legally adopts an infant and intends to personally breastfeed.
No, TRICARE doesn’t cover extended warranties.
This list of covered services is not all inclusive. TRICARE covers services that are medically necessaryTo be medically necessary means it is appropriate, reasonable, and adequate for your condition. and considered proven. There are special rules or limits on certain services, and some services are excluded.