Insurance — MoCo Lactation

Lactation support is not a luxury;
it’s a medical need.

Changes to our healthcare system are happening daily. MoCo Lactation is doing everything we can to keep our services affordable.

We are an in-network provider with many insurance plans. To check your coverage, please complete the form below and we will confirm your benefits. MoCo Lactation also offers self-pay options and will provide a superbill for you to submit for possible reimbursement from your insurance company.

*All in-home visits are subject to a travel fee.

Patient Name (mother/birthing parent/lactating parent)

First Name

Last Name

Phone

(###)

###

####

Primary Insurance Policy Holder

Name of Primary Insured (if different from patient)

First Name

Last Name

Insurance ID#

Insurance Company Name

Group Name or ID#

Birthdate of Primary Insured

YYYY

If baby(ies) is born AND on this insurance plan, please list the baby's name and date of birth

Baby's name and date of birth

If baby(ies) is not born yet, will baby be on this insurance plan?

Yes

Lactation support is not a luxury; it’s a medical need.

Changes to our healthcare system are happening daily. MoCo Lactation is doing everything we can to keep our services affordable.

Lactation support is not a luxury;
it’s a medical need.