1600 Boston Providence Highway Suite 232 Walpole, MA 02081 1-888-495-7491
 

3 Step Easy Order Form

Easy Ordering if You're Subscribed to a Qualified Plan


 

Breast Pump Easy Ordering

Get Started!

If you are 32 weeks or further along in your pregnancy and complete your order along with a prescription, we are able to ship most pumps same day! If you do not have a prescription yet, or are still in the early stages of your pregnancy, we will hold your order until you meet the necessary requirements for your insurance to cover your pump. Once you fill out your order form, there is nothing else you need to do except wait for your pump to arrive. If we do need your help, or have any questions, we will reach out to you. We ship to MA, RI, CT, NH, VT, Maine, and New York.


Mothers Information

Full Name*
Address*
City*
State*
ZIP Code*
Phone Number*
Email Address*
Date of Birth*
Baby Due Date*
Insurance Provider*
Insurance ID*
Physicians Name*
Physicians Tel Number*
Your Benefit Limit
MD Script: Upload Instructions ) Please fax to
1-508-404-1761
How You Heard About Us*

Authorization

I authorize Enos HBE to bill my Insurance Company for equipment listed above and I agree to pay any copays or other charges not covered by my insurance. Enos HBE will notify me prior to shipping of any listed copays. If for any reason my insurer denies the claim through no fault of Enos HBE, I will be notified that my credit card will be charged for the pump.

Signature*
(use mouse to draw your signature, or draw with finger on touch devices)
 
 
I acknowledge I have not received a personal use breast pump through this insurance policy or any other insurance policy for this pregnancy. I am at least 32 weeks pregnant or nursing an infant under 1 years old. 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 Healthy Baby Essentials.




Looking for Accessories?


Healthy Baby Essentials offers a variety of Accessories including The NuRoo Pocket in Black or Teal, The Nuroo Scarf as well as Freemie's Breastmilk Collection & Storage Bottle Set. If you subscribe to BC Mass, Tufts, Tufts Health Together, Harvard Pilgrim, BMC Health Net, Neighborhood Health or Health Plans, Inc. you can get your breast pump shipped today. All you need is a physician order and we take care of everything else and best of all shipping is FREE.
 
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