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BREASTFEEDING SUPPORT

Breast pumps, breast pump supplies and breastfeeding counseling are covered up to 36 months post birth for new mothers, including mothers who adopt an infant and plan to breastfeed. Breast pumps and breast pump supplies can be purchased before delivery, starting at 27 weeks of the pregnancy. One manual or one commercial off-the-shelf electric breast pump is covered per birth event.

A prescription from a TRICARE-authorized physician, physician assistant, nurse practitioner, or nurse midwife is required. The prescription must indicate the type of breast pump covered (basic manual, standard electric or hospital grade (if authorized)). The following supplies are covered when obtained by from an authorized provider:

For more information on what breast pump supplies are covered, please download the .

You can purchase the breast pumps or breast pump supplies from a TRICARE-approved provider, supplier, vendor, or any civilian retail store or pharmacy. You will be required to pay out-of-pocket and then submit the TRICARE DoD/CHAMPUS Claim Form - Patient's Request for Medical Payment (DD Form 2642) for reimbursement from the TOP Claims Processor. For more information on which breast pump or breastfeeding supplies are covered and reimbursable under TRICARE, and where you can purchase the pumps, please visit .

IF AN INTERNET PURCHASE IS MADE, WILL THE SHIPPING FEE BE COVERED? IF YES, ARE ONLY THE STANDARD SHIPPING CHARGES ACCEPTED? FOR EXAMPLE, IS PRIORITY SHIPPING COVERED?

Standard shipping costs are covered and factored into the cost of the item. Expedited or priority shipping costs are not covered for reimbursement. Below is a step-by-step process on how to obtain a breast pump and how to get reimbursed by the TOP Claims Processor.

HOW DO I OBTAIN A BREAST PUMP?
STEP 1: OBTAIN A PRESCRIPTION FROM A TRICARE-AUTHORIZED PROVIDER	You can obtain a prescription from a doctor, physician assistant, nurse practitioner, or nurse midwife. All beneficiaries overseas (TRICARE Prime, TRICARE Prime Remote and TRICARE Select) need this prescription for reimbursement. The prescription should indicate whether you're acquiring a basic manual or standard electric pump. If you need a hospital-grade pump, you'll have to collaborate with your provider and International SOS to secure a referral and authorization. The prescription doesn't need to mention a specific brand. If you plan to get your breast pump from a network provider or a durable medical equipment (DME) supplier, please ask your provider to include a diagnosis code on your prescription. It's recommended to keep a copy of your prescription for your records.
STEP 2: ACQUIRE A PUMP	For TOP Prime and Prime Remote enrolled beneficiaries, if you prefer not to make an upfront payment, reach out to your TOP Regional Call Center to locate a network provider or supplier. You'll need to present your prescription. If you're coordinating with a military clinic or hospital to obtain a breast pump, adhere to their specific processes and procedures. If making an upfront payment is not an issue for you, visit a TRICARE-authorized provider, supplier, or vendor. This includes both physical retail stores and online platforms. Remember to keep a copy of your receipt for future reference. In this scenario, there's no need to present 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, submit the following documentation to support the reimbursement process: Complete a DD Form 2642 Attach a copy of the prescription and receipt together with the DD Form 2642 Mail it to your TOP Claims Processor and they will reimburse you via check or Direct Deposit.

ARE HEAVY-DUTY HOSPITAL-GRADE PUMPS COVERED?

TRICARE covers heavy-duty hospital-grade breast pumps (including services and supplies related to the use of the pump) for mothers of premature infants only while the infant remains hospitalized during the immediate postpartum period. After the premature infant is discharged, continued use of a hospital-grade breast pump may be covered when a physician documents the medical reason for continued use. º£½ÇÂÒÂ×ÉçÇø must have a prescription from a TRICARE-authorized physician, physician assistant, nurse practitioner, or nurse midwife. The prescription must state which type of breast pump is covered.

TRICARE also covers electric hospital-grade breast pumps and supplies when needed for mothers and infants:

• Who are separated due to illness.
• Who are unable to feed directly from the breast due to medical reasons.

When a hospital-grade breast pump is no longer needed, you may be covered for a manual or commercial off-the-shelf electric breast pump; a new prescription is required.

IS BANKED DONOR MILK AVAILABLE OVERSEAS?

Currently, Human Milk Banking Association of North America (HMBANA)-accredited milk banks only exist in the continental United States and Canada. Therefore, Banked Donor Milk (BDM) is not available overseas, except for Canada. For more information, visit: .

HOW DOES BREASTFEEDING (LACTATION) COUNSELING COVERAGE WORK?

Under the current TRICARE benefit, you are covered for up to 6 individual outpatient breastfeeding / lactation counseling sessions per birth from a TRICARE-authorized medical provider (such as an obstetrician/gynecologist, physician, nurse, or midwife). As of January 1, 2025, TRICARE will introduce the Childbirth and Breastfeeding Support Demonstration (CBSD) overseas, which will effectively broaden that coverage to encompass outpatient sessions and services that can be offered by professionals trained in lactation consultation or counseling, but who may not be certified medical providers within TRICARE.

The CBSD will also include coverage for group breastfeeding counseling sessions, in addition to the previously covered individual breastfeeding counseling sessions. The 6-visit total outpatient session limit includes all individual and group counseling received under the current benefit and under the CBSD. For more information you can download CBSD Frequently Asked Questions (FAQ).

WHAT'S THE DIFFERENCE BETWEEN A LACTATION CONSULTANT AND A LACTATION COUNSELOR?

A Lactation Consultant can deliver all the services a Lactation Counselor can, along with extra services that might be required when intricate issues related to breastfeeding occur. You might prefer a Lactation Consultant over a Lactation Counselor for reasons such as your baby being underweight or born prematurely, or if you are breastfeeding multiple babies. Lactation Counselors are educated to offer breastfeeding guidance to aid in the normal lactation of breastfeeding parents of healthy, full-term babies.

Pregnancy Care Support Guides
TOP Pregnancy Brochure	This brochure contains all you need to know about pregnancy and delivery care applicable to TRICARE Prime Overseas and TRICARE Prime Remote Overseas beneficiaries.
Childbirth and Breastfeeding Support Demonstration (CBSD) Frequently Asked Questions Guide	This FAQ document will provide you with in-depth questions and answers on all aspects of the CBSD.
	This guide provides you with frequently asked questions and answers on TRICARE Policy requirements, breastfeeding pumps, and more.
Country-Specific Pregnancy Care Guides
	Comprehensive guides covering TOP midwifery services available in Germany for TRICARE Prime Overseas and TRICARE Prime Remote Overseas beneficiaries.
	A short guide on NIPT requirements and exemptions in Germany.