Insurance Coverage Program

Check Your Insurance Coverage for Willow

You may be eligible to purchase your pump at a discounted price. Please enter your information below.

What You’ll Need

A Signed Prescription

Insurance Card

OBGYN’s Information

Expectant and new moms are eligible to receive ONE breast pump per delivery. If you have recently received a breast pump through insurance, you are not eligible for a discounted Willow Pump.

Let's Get Started
Email Address*
Where do you live?
Who is your insurance provider?
Select Pump
Accessories
Accessories may be covered under your plan but will be initially charged at full price. If covered, you will receive a reimbursement check.
Referral Page
Insurance Provider
Company
Insurance Provider (Other)*
Order Summary
Item Name
Estimated Cost (USD)
Pump Name*
Pump Cost*
Accessory 1 Name
Accessory 1 Cost
Accessory 2 Name
Accessory 2 Cost
Accessory 3 Name
Accessory 3 Cost
Please Note
Pump and accessory costs are estimated and contingent upon insurance verification and approval.
Estimated Total (USD)
Out of Network Notice*
I agree.
Your credit card will be pre-authorized for the estimated amount. If you complete this order, you card will be charged for this amount. Based on your insurance coverage, your final cost may be less, in which case you will be reimbursed by Breastpumps.com for the amount covered by your insurance.

You may also return to Willow to purchase the pump at full retail price and submit the receipt to your insurer for possible reimbursement.
Breast pump to be provided by MedSource, LLC, in collaboration with BreastPumps.com and Healthy Baby Essentials. MedSource’s mission is to provide high quality durable medical equipment with a strong respect for patient rights. MedSource prides itself on having a caring manner combined with a high level of satisfactory service. They have been a Durable Medical Supplier since 1997 and became a Community Health Accreditation Partner (CHAP) in 2004.
Breast pump to be provided by Enos Home Oxygen and Medical Supply, Inc., in collaboration with BreastPumps.com and Healthy Baby Essentials. Enos Home Oxygen and Medical Supply, Inc., founded in 1950, is in its third generation of family ownership. They strive to meet every patient’s individual needs by providing the best equipment and service possible. They have been accredited by the Joint Commission’s Home Care Accreditation Program (JCAHO) since 1993.
Breast pump to be provided by Phoenix Medical Equipment in collaboration with BreastPumps.com and Healthy Baby Essentials. Phoenix Medical Equipment has been a Durable Medical Equipment supplier since 1982 and a Community Health Accreditation Partner (CHAP) since 1987. With a strong focus on location, dependability, and availability, Phoenix provides the highest level of service through attention to detail and patient care.
Breast pump to be provided by SunMed Medical LLC of New Jersey in collaboration with BreastPumps.com and Healthy Baby Essentials. SunMed was established in 2002 as a national provider of specialty medical equipment; providing the most clinically superior brands and sought-after models of each product they carry. SunMed has been accredited by the HQAA since 2010.

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Mother's Information
Mother's Name*
First Last
Mobile Phone*
Mother's Date of Birth*
Date Format: MM slash DD slash YYYY
Baby's Due Date*
Date Format: MM slash DD slash YYYY
Shipping Address*
Street Address City State ZIP Code

Save and Continue Later

Insurance Information
Policy Number/Member ID*
Find this on your insurance membership card (sometimes on back).
Group Number*
Upload Insurance Card*
Please upload a picture of the front and back of your insurance card(s). You can upload multiple images to this field.
Drop files here or

Accepted file types: jpg, jpeg, png, pdf, gif.
Mother's Relationship to Subscriber*
Relationship (Other)*
Do you have a prescription?*
Upload RX*
Accepted file types: jpg, jpeg, png, pdf, gif.
OBGYN/Midwife Name
OBGYN/Midwife Tel. Number

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Submit Order
Payment Details
Card Type*
Credit Card Number*
Expiration Month*
Expiration Year*
Security Code*
Cardholder's First Name*
Cardholder's Last Name*
Billing Address*
Billing City*
Billing State*
Billing Postal Code*
Estimated Cost (USD)
upon approved verification
Your credit card will be pre-authorized for the estimated amount. Your final cost may vary based on your verified insurance coverage. You will be notified via email of your approved coverage before your pump ships and the final amount is charged.
Based on your insurance selection, your insurance provider is likely considered out of network. You will be charged the full amount for your pump quoted here. Your breast pump will be billed by Breastpumps.com to your insurance provider after delivery and you will be reimbursed with a check for any portion of this purchase that your insurance pays. If your insurance requires any portion of your claim to go towards a deductible, co-insurance or co-pay, your payment here will be used for that purchase and no additional payment will be required. Please allow 4-6 weeks after the delivery of your pump for your insurance to process the claim and up to 2 additional weeks for your refund check to process (if applicable). If you do not want your insurance billed by Breastpumps.com for this pump, return to WillowPump.com to purchase a pump as a retail item.
Cardholder Signature*
Form Submittor Signature*
Disclaimer*
- Authorization and HIPAA Privacy Policy Consent
Acknowledgement*
- I have not received a breast pump order based on my benefit limit for this pregnancy.
Order Notes
Name
This field is for validation purposes and should be left unchanged.

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Check Your Insurance Coverage for Willow

What You’ll Need

Let's Get Started

Select Pump

Accessories

Order Summary

Mother's Information

Insurance Information

Submit Order

Payment Details