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Insurance Coverage Of Compression Pantyhose


Guest tearose

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Guest tearose

Does anyone have their compression pantyhose covered by their insurance company and how did you get it covered?

Did you have to write a letter for approval? Were they automatically covered?

thanks,

tearose

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If you are talking about jobst stockings, many insurances will cover them. Also many pharmacies or medical supply facilities will call to make sure your insurance covers them. They want to get paid, so they call for authorization.

Depending on what you want to get, most places will know whether they're going to be covered or not. You can also contact your insurance and ask them yourself. Good luck!! morgan

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You will want to check with your insurance and if they do cover them, you'll have to get a prescription for them from your doctor. Make sure he/she writes the compression level 20/30 or 30/40 on the slip and if it's to be thigh high or above the waist or the pharamcy won't know which ones you need. My insurance pays for all but 20.00 of the amount, and the amount billed for each pair is 130.00!!! That's just crazy for a pair of pantyhose, but if I didn't have insurance, I would probably have to surf ebay and find some there! It's amazing what a person can find at that site sometimes :huh:

Tammy

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in the years that i was wearing the hose i've had three different insurers and they have all covered the hose under durable medical. there has always been a limit of two a year, which, when i was quite active & wearing them all day every day didn't quite make it through the year (in regard to maintaining the compression) so i'd usually end up buying at least one additional pair out of pocket but obviously coverage for two pair was/ is still better than nothing. the coverage was always either 80 or 90% (depending on the policy i had at the time) unless i hadn't met my deductable yet (in which case i had to pay all) or unless i'd already met my out of pocket maximum (in which case i didn't have to pay anything).

all i ever needed for coverage was a properly written script. it generally needs to include the strength, style, AND the diagnosis.

i have been very blessed though with good insurance coverage over the years through my employer/ former employer. with all my health issues i still pay an arm & a leg out of pocket with co-pays, deductibles, co-insurance, but my insurance has still largely been pretty amazing.

in general, though, i would expect that if you have durable medical coverage there should be at least some coverage (unless there is a specific exclusion) as they are considered a durable medical item.

:huh: melissa

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hi tea, nice to hear from you!

although i'm not in your country i thought it would be nice to let you know that in the netherlands you need a prescription to get the hoses or stockings paid for. lately i asked the price, as i wanted an extra hose (2 are covered per year by insurance). i can't remember exactly how much it was but i do remember that i thought it was too much to just buy it. i think i'll have to ask santa for another hose this year :P:lol::lol:

take care,

corina :)

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Guest tearose

Thanks for the suggestions.

It looks like they are not covered at all if they are considered durable medical by mine.

Hmm..I wonder if they could be covered as a prosthesis?

Hey Mrs. B, good point however...green and red or purple and orange...I personally wouldn't care...I just want them!!!

Corina,

You will ask for something fun for christmas won't you.

best regards,

tearose

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actually, i was thinking of black, as that would fit my (still to buy) black skirt! but i LOVE your suggestion amy!!! i would look soooooo smart in green and red :)

tea, i am sorry that you're insurance doesn't cover the hoses you need. i wish i had an extra pair that fits you to send.

hope you can find a solution (i do understand that colour wouldn't be your problem as long as they would be covered!),

take care,

corina :)

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This is a GENERALIZATION but.... the majority of insurance carriers follow medicare guidelines when it comes to this type of thing. Private insurance will usually pay BETTER than Medicare but if Medicare out right denies coverage for a procedure or an item then the majority of private insuranc will also deny coverage.

This is the case for many folks when it comes to compression hose. Having said that, you may have a better chance for appeal with a private carrier but you would probably have to show substantial savings to the insurance company and have your DR write a detailed and thorough letter. For example, if compression hose lessened your ER visits then you could show the cost to them is a savings in the long run. It's a stretch in this case and you would still have to purchase them up front yourself to even know or prove this type of thing.

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I am sooo glad that we don't have to worry about insurance covering items in the UK. The 40mmHg stockings that I wear are only available on a hospital prescription from a specialist stocking clinic (my GP tried to prescribe me an extra pair), but we are allowed to have 2 pairs every 6 months, as they are supposed to last about 80-100 washes.

If I wanted extra pairs I would have to buy them over the internet from a foreign website such as ames&walker.

I must chase up my stocking clinic appointment as I must be due for new pairs about now (I have a hole in one pair and a run in the other pair - different compression strengths so I can't mix&match to make a "good pair").

Flop

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Guest tearose

thanks again for the suggestions.

My insurance, unfortunately does NOT cover these. They insist they are durable medical and this particular private insurance company (through my husbands employer) will not budge.

I have to work at a letter that explains and documents that I medically need these hose and am not able to treat my medical condition with any medications. I can only use the compression hose.

I am too tired to start writing that letter but hopefully soon...

tearose

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my insurance, which is quite good, does not cover any durable medical supplies... however, I did manage to get my nebulizer paid for b/c I'm part of their wellness program for those with asthma, and as a perk, my nurse manager authorizes payment for such things.

Nina

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