LACTATION DEPOT
INSURANCE DISCLAIMER & FINANCIAL RESPONSIBILITY AGREEMENT
Effective Date: 6/1/2026
By submitting an order, requesting insurance verification, enrolling in the Resupply Program, or receiving products from Lactation Depot, you acknowledge and agree to the following:
INSURANCE VERIFICATION IS A COURTESY
Lactation Depot may contact your insurance company to verify benefits and eligibility as a courtesy.
Insurance verification is not:
• A guarantee of coverage
• A guarantee of reimbursement
• A guarantee of claim approval
• A guarantee of payment
Coverage determinations remain solely the responsibility of your insurance carrier.
INSURANCE INFORMATION MAY CHANGE
Insurance carriers may:
• Modify benefits
• Change eligibility requirements
• Require prior authorization
• Apply exclusions
• Deny claims
• Retroactively adjust claims
Information received during verification may differ from the final claim determination.
CUSTOMER RESPONSIBILITY TO UNDERSTAND BENEFITS
You are responsible for understanding your health plan, including:
• Deductibles
• Copayments
• Coinsurance
• Coverage limitations
• Frequency limitations
• Prior authorization requirements
• Exclusions
Lactation Depot cannot guarantee the accuracy of information provided by insurance representatives.
FINANCIAL RESPONSIBILITY
You agree to be financially responsible for all amounts not paid by your insurance carrier, including:
• Deductibles
• Coinsurance
• Copayments
• Upgrade fees
• Non-covered products
• Non-covered replacement parts
• Denied claims
• Retroactively denied claims
• Eligibility-related denials
• Insurance recoupments
UPGRADE PRODUCTS
Certain breast pumps and products may require an upgrade fee.
Upgrade fees must be paid prior to shipment and are non-refundable once products have shipped.
DUPLICATE EQUIPMENT ATTESTATION
By placing an order, you certify that you have not previously received the same insurance-covered product for the current eligibility period unless permitted by your insurance plan.
PRESCRIPTION REQUIREMENTS
Certain products require valid prescriptions and supporting documentation.
Lactation Depot reserves the right to delay, suspend, or cancel fulfillment pending receipt of required documentation.
COLLECTION OF UNPAID BALANCES
Any balance remaining unpaid after thirty (30) days may be referred to collections.
You agree to pay reasonable collection costs, attorney fees, court costs, and interest permitted by applicable law.
AUTHORIZATION TO BILL INSURANCE
You authorize Lactation Depot to submit claims, corrected claims, appeals, and supporting documentation to your insurance carrier as necessary to obtain reimbursement.
NO GUARANTEE OF COVERAGE
You acknowledge that:
• Insurance verification is not insurance approval.
• Insurance verification is not a guarantee of payment.
• Shipment of a product does not guarantee insurance reimbursement.
• Insurance coverage determinations remain solely the responsibility of the insurance carrier.
ELECTRONIC SIGNATURE
By checking an acknowledgment box, signing electronically, submitting an order, or accepting products from Lactation Depot, you acknowledge that you have read, understand, and agree to this Insurance Disclaimer & Financial Responsibility Agreement.
CONTACT INFORMATION
Lactation Depot
www.lactationdepot.com