Breast Pump Eligibility Form

Please provide us with the following information and we will do the rest!

Please allow 7-10 business days for order processing, then 2-3 days shipping to your home.
Commercial health providers are now required by law to allow breast pumps as a covered expense for lactating women. There is some variation around co-pays and model availability, depending on your health insurance carrier and plan.
Please note: Not all insurance plans provide coverage for breast pump purchases.
KS Medicaid is accepted.

However, we are unable to process orders with other State Medicaid plans, please contact your insurance provider directly.
MO MEDICAID INELIGIBLE, TX MEDICAID INELIGIBILE