Does Private Insurance Cover Compression Garments
In January 2024, as part of the Lymphedema Treatment Act (LTA), Medicare began to provide coverage for compression garments that are needed for the management and treatment of lymphedema. After that, some private insurance companies began to follow suit and provide similar coverage.
Below are general points to consider about private insurance coverage and the pros and cons of trying to use it for obtaining your compression garments.
- Insurance Plan Coverage
- 10% discount for first-time customers (discount code: BPWELCOME)
- 5% ongoing discount for all customers who place their orders online (discount code: BP5)
Insurance coverage can vary significantly between different health insurance plans. Some plans might cover the full cost of compression garments, while others might only cover a portion, or none at all. It is important to check the specific details of your insurance policy and also to factor in your co-pay and deductible set by your individual plan.
Medical Necessity
In most cases, health insurance companies will only cover compression garments if your healthcare provider deems that they are medically necessary. This could be for conditions such as lymphedema, chronic venous insufficiency, post-surgical recovery, or other medical conditions that require compression therapy.
Prescription Requirement
Typically, a prescription from a healthcare provider is required for the insurance company to consider covering the cost of compression garments. It is common practice for the insurance company to require that the written and signed prescription detail your medical condition, need for the compression garment, type of compression garment, compression level, frequency of use, and more.
Pre-Authorization
Some health insurance plans might also require pre-authorization before you can purchase compression garments. This means that you will need to get approval from the insurance company BEFORE you buy a compression garment. Once you submit your request, the insurance company will review it and notify you of their decision, which could take anywhere from a few days to several weeks.
Medical Supplier Requirements
For the cost of your compression garment to be covered, most health insurance companies will only allow you to buy from suppliers that they have approved. These could be in-network providers and/or specific medical supply companies which they have established contracts with. Based on contracted reimbursement rates, these medical suppliers might not be able to supply the compression garments that you prefer. Also, these suppliers may charge higher prices for insurance-covered garments which could affect your out-of-pocket costs, depending on your deductible and co-payment rate.
Bandages Plus is not set up to bill any private insurance plans, however, there are significant benefits in ordering directly from Bandages Plus and you are still able to file a claim directly with your individual insurance plan. Please refer to your particular plan regarding the details of filing a claim.
Quality Of Products
Oftentimes, the compression garments that are covered by health insurance companies are the most “basic” type. If you prefer a compression garment that has more features (such as a printed pattern, a silicone grip band that helps keep the garment in place, a custom fit, etc.), it is less likely that the product will be covered by your insurance company.
Convenience
If you need your compression garment right away and/or you want to avoid the hassle of trying to get your insurance company pay for it, you might prefer to order directly from us. At Bandages Plus, you can order all of our products without a prescription. Ordering is simple (by phone or online), and you are able to choose the shipping method for delivery, based on your personal needs.
Discounts For Ordering Compression Garments From Bandages Plus
We already offer some of the most competitive pricing in the industry! In addition, we are pleased to offer discounts if you decide to purchase compression garments from us:
Let Us Help You
Since 1992, we have been providing lymphedema compression garments and bandaging supplies, and we offer exceptional customer service! If you have any questions or need help placing an order, please contact us at (800) 770-1032 or info@bandagesplus.com.
Medicare Coverage For Compression Garments: Please note that the information above applies to private insurance companies. Click here for information about Medicare coverage for compression garments.
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See Related Lymphedema Treatment Act Topics:
Why Order Compression Garments From Bandages Plus
Does Medicare Cover Compression Stockings