Obtaining Insurance Coverage for Compression Garments


Compression garments such as stockings, sleeves, gloves, and support socks are often a necessary part of recovery from sports injuries or serious medical conditions. When your doctor prescribes compression garments for your recovery, will your insurance company cover the costs?
Whether or not support socks and other compression garments are covered by your specific insurance company can only be answered by contacting your provider. However, there are some generalizations which might guide your initial research.
The Type of Garment
Any of these answers may vary from one insurance company to another. You should always check with your insurance company for specific coverage. However, some of the most common compression garments to be covered by insurance companies include:

  • *Inflatable compression garments
  • Non-elastic binders and elastic leg binders
  • Graduated compression stockings
  • Compression sleeves and gloves
  • Support stockings

Some of these items may be considered to be outpatient consumables. These may not be covered by your specific insurance plan. However, it is better to contact your insurance company than to assume that the items won’t be covered.
*Inflatable compression garments are often considered to be experimental and may not be readily covered by all insurance plans.
The Type of Treatment
Certain medical conditions require the use of compression garments to prevent worsening conditions and more costly courses of medical treatment. Some of these conditions may include:

  • Chronic venous insufficiency
  • Edema
  • Lymphedema
  • Thrombosis
  • Post thrombotic syndrome
  • Postural hypotension
  • Tendonitis

There are naturally variations in the degree of severity for the conditions. You may find that the severity of your condition is a factor when coverage for these garments is decided.
Replacement for Compression Garments
If your insurance plan has already provided coverage for the necessary compression sleeves or stockings, then you can usually expect any necessary replacements to be covered, within reason. You may need to provide proof that the garment cannot be repaired or that the existing garment is no longer appropriate for your condition. When the need for replacement arises, check with your insurance provider to ensure that coverage will be available.
Many insurance companies will limit the number of replacements per year and some insurance companies will provide coverage for more than one pair of compression garments so that you have one available while the other is in the laundry.
Reimbursement Coverage
In cases, the supplier of your compression socks won’t bill your insurance company. Under these circumstances, you will need to pay for the garments yourself and then apply to your insurance company for reimbursement. When this is the case, you’ll want to follow some important steps to ensure that your purchase will be covered.
Limits to the Coverage
There are often conditions made by insurance companies when coverage is an option. These conditions include:

  • Carefully follow all of the physician’s instructions regarding use of the compression sleeves, stockings, and other garments.
  • Documentation of the order from the supplier with dates and other identifying information.
  • The number of garments covered by the insurance provider may be limited.
  • Measurement and fit of the garment should be verified by a qualified doctor or medical provider.

It is always important to check with your insurance provider rather than assuming that coverage will be provided.
One Last Tip:
One final tip involving the purchase of compression garments when you hope for insurance coverage involves working with a supplier that has experience working with insurance companies. Ask your doctor to recommend a supplier that understands the challenges of working with insurance providers.
About the author: 
This post was written by Don Johnson.


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