Ameda | Insurance

Experience the Ameda difference for yourself.

Fill out the following form to see if you qualify for a free Ameda pump through your insurance. One of our trusted partners will be in contact with you once your form has been completed and received.

Nurturing your body to nourish your baby starts here.

First Name*

Last Name*

Email*

State related to your Insurance Plan

Primary Insurance Plan

Baby's Birth/Due Date

By clicking next, you are agreeing that Ameda can contact you with updates about qualifying for your free pump.

Step Two

Personal Information
Step Three

Permissions
Step Four

Summary & Submission

Personal Information

Please fill out the following information as it applies to the patient.

First Name*

Last Name*

Insurance ID*

Date of Birth*

Gender

Female

Male

Address Line 1*

Address Line 2

City*

State*

Zip*

Email*

Phone Number*

Confirm Email*

What is your baby's date of birth/due date?

Is the Patient the Policy Holder/Primary Subscriber for this claim?*

Yes

Please attach a digital copy of your insurance card to help us speed up the process (Optional).

Front View

Back View

Enter the healthcare provider information of the doctor who prescribed the breast pump

State where the OBGYN is located?*

OBGYN Last Name*

OBGYN First Name (Optional)

NPI #

OBGYN Phone Number

Previous Next

Permission

Select "Yes" to allow us to share your information with one of our trusted partners.

Yes, I give my permission to share information with supplier.
No, I do not give my permission to share information with supplier.

*Please note: If you select no, we will be unable to share your information with a pump supplier.

We respect your privacy. To learn more about our HIPAA compliance, click here.

Previous Next

Summary & Submission

Shipping State :

Insurance Plan :

Baby Birth Date :

First Name :

Last Name :

Insurance ID :

Date of Birth :

Gender :

Address line 1 :

Address line 2 :

City :

State :

Zip :

Email :

OBGYN First Name :

OBGYN state :

OBGYN Last Name :

NPI# :

OBGYN Phone Number:

Relationship to Policy Holder :

Check to enroll in our free program and receive breastfeeding tips, education and access to experts.

MILK 101

The easy guide to getting a free breast pump through insurance.

LEARN MORE

FAQs

Got questions? We got answers! Check some of our most common questions and answers.

LEARN MORE

Meet Mya: Pump
On-The-Go.

Key Feature Comparison	Mya	Mya Joy
Size (L x W x H)	4 x 3.5 x 1.75″	4.3 x 3.6 x 2.16″
Kit Type	Mya Kit	HygieniKit*
Suction strength	up to 280mmHg	up to 250mmHg
Battery type	Lithium ion	4 AA batteries
Levels of expression	10 levels	12 levels
Massage stimulations	5 levels	6 levels
Battery life	2 hours	1.5 hours
Backlit digital LCD Display
True closed protection system
Double or single electric pumping options
2-year warranty
Automatic power off technology after 45 minutes
Timer display to track pumping time
Memory function to remember last used setting
Ultra quiet to allow discreet pumping anywhere
Independently adjustable speed & suction	Amada	Amada
Handle w/built-in nightlight for portability	Amada	Amada
Belt clip	Amada

*Only Use the Diaphragms and Valves that come inside the Mya Joy pump.

Experience the Ameda difference for yourself.