Did you know that Medicare, some Medicaid programs and most private insurance carriers, will reimburse your purchase of recovery garments, post-surgical bras and prostheses? And you don’t need to be recently diagnosed. Survivors using these products are also covered. Standard Medicare Part B reimbursement is 80% of your out-of-pocket cost up to approved limits based on the current CMS Fee Schedule. Most Medicare supplemental insurance plans will cover the remaining 20% as will some secondary insurance carriers.
If you are not a Medicare recipient but have a private insurance carrier, your out-of-pocket costs for these items may also be covered. This coverage varies based on your carrier and your plan.
At the present time Medicare and most insurance companies do not cover the cost of your wigs, except in special cases. However, some insurance carriers have started providing this coverage so be sure to check with yours.
Unfortunately, compression garments are not covered by Medicare. However, sometimes Medicaid and some private insurance companies will provide coverage for compression sleeves and gauntlets so be sure to check on this as well.
Second Act is an approved Medicare provider with full billing privileges. We are also an in-network provider with Blue Cross Blue Shield of IL and Aetna insurance, and traditional State of IL Medicaid. If your insurance is with another carrier, check with them about your out-of-network benefits as many plans offer this coverage.
What do you need to do to take advantage of your coverage?
Whether using Medicare, Medicaid or private insurance when purchasing covered items, you must bring a prescription from your physician in order to receive insurance reimbursement. And, if you have an HMO plan you will need an approved referral, just as with other medical services. The information required on your prescription is very specific. Here is a sample for you to provide to your physician.
Remember, even though your physician has provided a prescription for your purchases, this does not guarantee your insurance carrier will reimburse you. It is important that you check with Medicare and/or your private insurance carrier for details of your plan before visiting Second Act.