IMPORTANT: Our primary method of contact is email. Please provide an email address you check regularly.
I acknowledge I have not received a personal use breast pump through this insurance policy or any other insurance policy for this pregnancy. I understand if I have received a breast pump through another provider or insurance coverage this claim may be denied and I will be responsible for paying the full retail value of the breast pump to Neb Doctors.
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I have a prescription for a breast pump:
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I have a secondary insurance
I acknowledge that if I have coverage under more than one insurance policy that I have listed both insurances in the proper Primary and Secondary insurance sections. If I do not, I may be responsible for payment in full if my claim is denied by the Primary listed insurer.
As an accredited medical supplier, Neb Doctors is required to document disclosure of several policies to each of our customers.
I certify that I have reviewed, understand and accept the terms and conditions disclosed here.
I'm Upgrading for the Preferred Breastfeeding Experience I've indicated by this checkbox selection, I approve the Upgrade Waiver; I have been offered the standard double electric breast pump that is fully covered by my insurance; however, I am opting to upgrade to a deluxe model. I am aware that the breast pump I am purchasing is a deluxe model and will be responsible for the difference between the reimbursement rate for the standard model and the deluxe model. (Sales tax will be charged in applicable states).