Does CareSource Cover Breast Pumps? Ordering and State Rules

Yes, CareSource does cover breast pumps. Eligible members get one standard electric or manual pump per pregnancy at no cost, along with core supplies, and most pregnant members can place an order within 90 days of their due date through an in-network durable medical equipment (DME) supplier with no prior authorization required for a standard pump.¹²

What You Get With the Pump

The covered pump itself comes at no charge, and members can pick from a catalog of brand-name models including Ameda, Ardo, Evenflo, Freemie, Lansinoh, Medela, Spectra, and Zomee.³

Essential supplies are included: tubing, adapters, bottle caps, locking rings, polycarbonate bottles, breast shields, and splash protectors.¹ Replacement parts follow a set schedule. Tubes, shields, and bottles are covered once every six months, and disposable collection or storage bags are covered up to 100 per month.³

Items CareSource treats as convenience purchases are generally not covered. That category includes standalone storage or freezer bags, containers, bottles, and nipples bought on their own.¹

How to Order Your Pump

The process has three steps.

Pick a model. Compare pumps by portability, noise level, and what supplies come in the box. Checking reviews and asking your provider helps narrow the choice.²
Place the order with any in-network DME provider, in person or online. CareSource lists several partner vendors members can order from directly, including Aeroflow Breastpumps, Ameda Direct, and Pumps for Mom.²
Receive it. The pump ships directly to you.⁴

Some premium models carry an upgrade fee. If you choose one, you pay only the difference between the covered amount and the retail price.

Hospital-Grade Pumps

Heavy-duty hospital-grade pumps are also covered, but only when medical criteria apply. CareSource will authorize one if the breastfeeding infant is hospitalized, or if the infant has a condition that makes breastfeeding difficult, such as a cardiac, respiratory, or genetic condition, or a cleft palate.¹

These pumps are provided as rentals, not purchases, at $2.25 per day for up to 90 days.³ The published medical policy does not spell out whether prior authorization applies, but the 2026 Ohio Marketplace prior authorization list requires PA for all rental or lease DME, which would cover a hospital-grade pump rental.⁵ Call Member Services or have your provider confirm what documentation is needed before ordering.

How Coverage Varies by State

The core benefit is the same wherever CareSource operates, but some details shift with state Medicaid rules and plan type.

Ohio

Ohio Medicaid requires every managed care plan to cover breast pumps. Members get one pump per 12 months and up to 120 breast milk storage bags per month at no cost.⁶ CareSource’s Ohio policy covers one standard electric or manual pump per pregnancy with the supplies listed above.¹ Edwards Health Care Services is one in-network DME option.⁷

Indiana

CareSource Indiana Medicaid provides a free pump to any nursing mother who requests one, with no prior authorization needed for standard orders.⁸⁴ Order through Aeroflow, Ameda Direct, Pumps for Mom, or another in-network DME supplier.²

Georgia

Georgia members, including those enrolled in the Planning for Healthy Babies (P4HB) plan, can get a pump at no cost. Aeroflow and Ameda Direct are the listed partner vendors.⁹ Lactation services are a covered Medicaid benefit in Georgia as well.¹⁰

Kentucky

Kentucky Medicaid offers one free breast pump per pregnancy to every member regardless of managed care organization, so CareSource Kentucky members receive the benefit under the statewide mandate.¹¹

West Virginia

West Virginia Marketplace coverage mirrors the standard framework: one electric or manual pump per pregnancy, the same supply set, and the same medical criteria for hospital-grade rentals.¹² Benefit questions go to Member Services at 1-833-230-2099.¹³

Lactation Help and Pregnancy Care Management

Coverage goes past the pump itself. Lactation consulting is a covered service, and Ohio Medicaid began reimbursing separately for consulting by practitioners who hold the International Board Certified Lactation Consultant (IBCLC) credential effective December 2024. The policy covers office and home visits by eligible providers, including registered nurses, dietitians, and doulas who also hold the IBCLC designation.¹⁴

CareSource also runs a pregnancy care management program, Mom and Baby Beginnings, that assigns a care manager to help coordinate medical care, arrange transportation, connect members with doula support, and assist with obtaining a pump.¹⁵ Enrollment is at 1-833-230-2034.²

If Your Request Is Denied

You have the right to appeal a denied pump claim or a denied hospital-grade pump request.

File an internal appeal within 60 calendar days of the denial notice. You can submit by phone, mail, fax, or through the provider portal, and include your name and ID number, the provider’s name, the date of service, the reason for disagreement, and any supporting medical documentation.¹⁶
Ask for an expedited review if the standard timeline could put your health at risk. Expedited decisions come within 72 hours; in Indiana, expedited clinical appeals are resolved within 48 hours.¹⁶¹⁷
Request an independent external review if the internal appeal is denied. In Indiana, you must request it within 120 calendar days of the appeal determination, and the review organization’s decision is binding.¹⁷

1
CareSource. Breast Pumps and Lactation Services Policy MM-0108
2
CareSource. CareSource Indiana Breast Pump Flier
3
CareSource. ProviderSource Newsletter
4
CareSource. CareSource Indiana Q4 ProviderSource Newsletter
5
CareSource. 2026 Ohio Marketplace Prior Authorization List
6
Ohio Medicaid. Maternal-Infant Plan Value Added Benefits Information
7
Edwards Health Care Services. CareSource Breastpumps
8
CareSource. Compassionate Care Mother and Child Resource Guide
9
CareSource. Georgia P4HB Pregnancy Page
10
CareSource. Georgia Medicaid Additional Services
11
Kentucky Health Benefit Exchange. 2026 Medicaid Maternal Health and Wellness Resource Guide
12
CareSource. West Virginia Marketplace Breast Pump Policy MM-0986
13
CareSource. West Virginia Marketplace Member Handbook
14
CareSource. Access to Lactation Consulting Services for Medicaid Beneficiaries
15
CareSource. Mom and Baby Beginnings Bundle Flier
16
CareSource. Georgia Pathways File an Appeal
17
CareSource. Indiana Medicaid Provider Appeals