THE REAL QUESTION IS…
Will my insurance company cover my compression garments? Will Medicare cover my compression garments? Sometimes yes, but more often they will not. If they do pay, the real question is, how much will they pay? It’s all part of the medical insurance game. The other day I needed to purchase a prescription drug. I was shocked when they told me the price was over $600. When I explained to them I did not have insurance to cover this drug, they said, “Oh, then we can give you a discount, it will now be only $60.” How can that be? How can a drug price drop that drastically?
I have worked in different capacities in the medical field on and off for the past 45 years. I have seen the evolution of the insurance industry and how it interacts with the medical profession. In my opinion, it has continually declined, possibly to the point of no return. It has all become big business and the patient is definitely the one on the short end.
The games the medical profession and the insurance companies play leaves those who need medical care stranded in the middle. This is one reason I have elected to opt out of the insurance game. Often, medical professionals are billing three times (if not more) the value of a compression garment just to get their “fair share” after the insurance companies take their cuts. The problem is the customer often ends up paying more, through their deductibles and co-pays, than if they would have paid cash up front. It’s a vicious cycle. The medical professionals inflate their cost, so the insurance companies take more off of their reimbursements, and then the medical professionals have to raise their rates, likewise the insurance companies pay less and less, if at all. It’s a game of deception and greed.
By creating The Compression Closet, I can provide the lymphedema therapists and their patients with an alternative to the insurance game. One of the reasons I created my own business was so that I could run it the way I saw fit with integrity and honesty. There are no shell games and no hidden costs here. I no longer have to play the game I did when working with the insurance companies and neither do you.
WORKING WITH YOU
Compression is not cheap, no one knows this better than I, but I am continually working with my therapists, as well as their patients, to provide them with the very best compression for the very best value I can. I also provide receipts with the necessary HCPC coding to submit to your insurance company, if you wish to seek reimbursements. When you submit that bill you will know that you have paid an honest price for a quality product. No games, no lies, no inflated pricing or double billing.
A BETTER SOLUTION
Overall, it’s important to note that when it comes to compression, many insurance companies won’t cover garments – so it’s critical to check with your insurance company to learn more about your coverage. You will need your diagnosis and the HCPC code of your compression garment. It’s important to know the percentage the insurance company will pay and what percentage will be your responsibility. You may just find that it will be less expensive if you purchase your garments up front and then submit the paperwork for possible reimbursement. Whether they will reimburse you or not, know that at The Compression Closet, we will do our best to continue to give the highest quality compression garments for the best value!
For further information about medicare coverage: