Medicare Coverage For Lymphedema Supplies: A Checklist
In 2024, with the passage of the Lymphedema Treatment Act (LTA) Medicare started covering compression garments and bandaging supplies that are used for the treatment and management of lymphedema. A wide range of products for lymphedema are covered, including: compression garments, gradient compression wraps, compression bandaging, donning aids, and more.
There are several steps which you must go through in order to obtain your lymphedema products and have them covered by Medicare. To help minimize the confusion, we have created the following checklist which you can use.
STEP 1: Determine Your Eligibility
The first step in determining whether you are eligible to receive coverage of your lymphedema products under the Lymphedema Treatment Act is to answer several simple questions. If you are able to answer “Yes” to ALL of the following questions, then you are likely eligible to have Medicare pay for your covered lymphedema products:
______ I have Medicare Part B coverage.
______ I have seen a doctor or other authorized healthcare provider in the past 6 months about my condition.
______ I have received a documented diagnosis of having lymphedema.
______ My healthcare provider has documented a plan of care for treating my lymphedema.
______ I have a written, signed prescription from my healthcare provider for products that will be used to treat my lymphedema.
______ My medical condition and plan of care has been sufficiently documented in my medical records, to include:
- ______ diagnosis codes,
______ the stage/phase of lymphedema,
______ duration of treatment,
______ anatomical location (e.g. arm, leg),
______ description of products needed for treatment, and
______ frequency of product replacement.
STEP 2: Find An Enrolled DMEPOS Supplier
To obtain your lymphedema products under the Lymphedema Treatment Act, you must order your products from an enrolled Medicare DMEPOS (Durable Medical Equipment, Prosthetics, Orthotics, and Supplies) supplier. There will be several steps involved in placing your order with the DMEPOS supplier. Each step must be completed prior to receiving your products, and any delays in completing a step will likely lead to a delay in receiving your order:
______ The company that I will purchase from is an enrolled Medicare DMEPOS supplier.
______ The Medicare DMEPOS supplier will be able to supply the exact products that my healthcare provider has prescribed.
______ I have provided a HIPPA release form to the DMEPOS supplier.
______ I have provided a financial responsibility form to the DMEPOS supplier, if requested.
______ The DMEPOS supplier has sent the HIPPA release form to my healthcare provider.
______ My healthcare provider has released my documented medical records to the DMEPOS supplier.
______ I have been measured for the requested garments to ensure a proper fit.
______ I have been trained on how to correctly use and maintain my lymphedema products.
______ I have paid the annual deductible (if not already met) and paid the 20% Medicare co-pay.
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Click here to see a printable version of our Medicare Coverage For Lymphedema Supplies Checklist.
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See Related Lymphedema Treatment Act Topics:
Why Order Compression Garments From Bandages Plus
FAQs About The Lymphedema Treatment Act