At Breastfeed Durham, we are thrilled to share some encouraging news that reflects meaningful progress in our ongoing efforts to ensure equitable access to breastfeeding support.
Julie Ghurtskaia, Vice President of Population Health at Carolina Complete Health, recently shared an exciting update: Carolina Complete Health now offers streamlined access to breast pumps for members—no prior authorization required.
This change means that members can now obtain breast pumps directly from a network Durable Medical Equipment (DME) provider without jumping through administrative hoops. As a Prepaid Health Plan (PHP), Carolina Complete Health has opted to go beyond the minimum state requirements and make breast pump access easier for the families they serve.
“We have the allowance to be less stringent than the state policy, and we have chosen to exercise this for breast pump coverage,” Julie shared.
This approach marks a significant shift in reducing barriers to lactation support—something we advocate for every day. It also acknowledges that breastfeeding should not require a diagnosis or a crisis to be supported.
Carolina Complete Health has also added a notation on their Clinical Policy webpage, clarifying that coverage for breast pumps applies regardless of the medical necessity criteria outlined in policy 5A-3. This decision aligns with our values and mission at Breastfeed Durham and shows what’s possible when health plans center the needs of families.
We are deeply grateful for this collaboration and for the leadership shown by Julie and her team.
Breastfeed Durham will continue to work with partners across the state to implement policy, systems, and environmental changes to normalize breast, chest, and human milk feeding.