Does Medicare Cover Compression Stockings
When the Lymphedema Treatment Act (LTA) took effect on January 1, 2024, Medicare began to cover compression stockings, compression socks, and other types of compression garments and bandaging supplies that are used for the treatment and management of lymphedema.
- What Does Medicare Coverage For Compression Stockings Include
- provided a diagnosis that you have lymphedema
- written a prescription for the compression stockings (you MUST have a signed prescription)
- sufficiently documented your medical condition and a plan of care for treating your lymphedema that includes:
- diagnosis code
- stage/phase of lymphedema
- duration of treatment and need for products
- anatomical location that requires treatment (e.g. your legs)
- type, description, and quantity of products needed for treatment (e.g. 20 - 30 mm Hg compression stockings)
- measurements for the compression stockings
- frequency of product replacement (e.g. every 6 months)
- HIPPA release form (authorizes your medical provider to release your personal medical records to the DMEPOS)
- financial responsibility form (guarantees that you will pay the DMEPOS for any charges not covered by Medicare
- you are not eligible for Medicare coverage under the Lymphedema Treatment Act
- you have not been diagnosed as having lymphedema (Medicare coverage for products to treat venous insufficiency is not covered under the LTA)
- you have not seen your medical provider within the past 6 months and/or lack sufficiently documented medical records
- you do not have a prescription for compression stockings for lymphedema treatment
- you need your compression stockings quickly
- you do not want to go through the hassle it will take to get compression stockings from a DMEPOS supplier
- you have exceeded the number of compression stockings allowed (see above)
- you want higher quality compression stockings than an enrolled DMEPOS supplier will provide
- 10% discount for first-time customers (discount code: BPWELCOME)
- 5% ongoing discount for all customers who place their orders online (discount code: BP5)
Medicare will cover 3 daytime compression stockings and 2 nighttime compression stockings for each affected limb, every 6 months. It is important to note, however, that Medicare has a fixed reimbursement rate that they will pay, regardless of the type of compression stocking that you get. Medicare coverage typically will only extend to compression stockings on the lower end of the scale that might not include features that you would prefer (e.g. a silicone bead band at the top of the stocking that helps prevent it from sliding down).
How Much Do I Have To Pay For My Compression Stockings
As with any other Medicare claim, you will need to pay a co-pay (typically 20%) on your compression stockings, and meet your deductible for the year.
What Are The Eligibility Requirements For Medicare To Cover Compression Stockings
In order to qualify for Medicare coverage for compression stockings, you will need to have seen an authorized medical practitioner sometime within the last 6 months who has:
Where Can I Get Compression Stockings That Medicare Will Cover
In order to get compression stockings that Medicare will cover, you will need to order them through a Medicare enrolled DMEPOS supplier. A DMEPOS supplier is someone who sells durable medical equipment, prosthetics, orthotics, and supplies. Or, you can order compression stockings directly from us and submit a claim directly to Medicare for reimbursement.
Is Bandages Plus A DMEPOS Supplier
We are not a DMEPOS supplier, but there can be significant benefits in ordering directly from Bandages Plus.
What Information Does The DMEPOS Supplier Need From Me
In order to fill your order, a DMEPOS supplier will need:
All of these forms will need to be completed and returned to the DMEPOS supplier before they are able to process your order. Additionally, your medical provider will have to send your personal medical records containing the required documentation, to the DMEPOS before your order can be processed. Any delays in receiving the required forms from the parties involved will certainly impact and delay the timeframe in which you can expect to receive your order.
What Are The Advantages Of Ordering Compression Stockings From Bandages Plus
There are many circumstances in which you might prefer to order compression stockings directly from us, including:
Can I Order Compression Stockings From Bandages Plus And Submit A Claim To Medicare
Yes, you can order compression stockings from Bandages Plus and submit a claim for reimbursement from Medicare.
Does Bandages Plus Provide Any Discounts On Compression Stockings
Yes, we have some of the most competitive pricing in the lymphedema products industry, and we are also pleased to offer:
When you consider the Medicare 20% co-pay, compared to the Bandages Plus discounted pricing, it might make sense to get the exact products you want by purchasing directly from us, without the hassle and long wait times of purchasing through a DMEPOS!
Does Private Insurance Cover Compression Stockings
Some private insurance companies will cover compression stockings, but the reimbursement rates may be even lower than the rate that Medicare pays. This means that many DMEPOS suppliers might have to furnish a very basic stocking, or they simply might not be able to offer compression stockings through your private insurance.
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See Related Lymphedema Treatment Act Topics:
Why Order Compression Garments From Bandages Plus
Medicare Coverage For Lymphedema Supplies: A Checklist