Let's Check Your Insurance Benefits
You may qualify for insurance-covered lactation care! Complete the information below so our team can review your benefits and determine which care options are available through your insurance plan.
Is This the Right Insurance Form for You?
This form is for families who have either of the following:
Look at the front or back of your insurance card. If it says "Blue Cross Blue Shield of Massachusetts", you're in the right place!
Please note: Not all Blue Cross Blue Shield plans are issued through Massachusetts. We will verify your specific plan before confirming eligibility.
If your health insurance is provided through one of these employers, please complete this form so we can review your specific benefits and determine whether you qualify for our program.
Important: Having one of the insurance plans or employers listed above does not automatically guarantee coverage. Our team will review your benefits to determine eligibility.
Please Read Before Completing This Form
We are not currently accepting the following insurance types through this program:
- Marketplace / Exchange plans (Affordable Care Act plans)
- Medicaid / MassHealth
- TRICARE
If you have one of these plans, please contact our team before submitting this form to discuss available options.
What We Need to Verify Your Benefits
To help us complete an accurate eligibility review, please:
- Complete every section of this form.
- Upload clear images of the front and back of your current insurance card.
- Enter the policyholder's information exactly as it appears on the insurance card.
- Tell us about any additional insurance coverage, even if it is secondary.
- Use the insurance plan that will be active on the date of your appointment.
Providing complete and accurate information helps us verify your benefits more efficiently and reduces delays in getting your care scheduled.
Important: Insurance eligibility verification is not a guarantee of coverage or payment. Your benefits, plan requirements, and final claim processing determine the amount your insurance company will cover.
Complete the insurance verification form below. Once our team reviews your benefits, we'll contact you with your eligibility information and the next steps for scheduling your lactation care.
Our goal is to review submitted insurance information and follow up within 24 business hours.