Requirements

The #1 question we are asked is, “will insurance cover this?”

In this section we outline a few guidelines that may provide some answers to that question.

Know your Rights

By Federal Law, for individuals under the age of 21 who are eligible for Medicaid, Medicaid in all 50 states must approve whatever DME product the clinician prescribes as long as it is sufficient in amount, duration, and scope to the original intent of the prescriber.

HOWEVER

There is only so much a medical retailer (DME) can do for you. Ultimately the family has the power and responsibility to see that your rights are being met. It may be necessary to approach the courts to see that the provisions already present in federal law are being met by your state or private insurance provider.

Sample Letter

Most insurance providers will require a letter of medical necessity (LOMN). Very often the LOMN is the difference between getting a bed approved by insurance or not. We have a sample letter that contains some key elementsLetter to Insurers.

PLEASE research additional sources including the internet but also gather information from your DME, your insurance company, physician, therapists, etc.

No letter is perfect. No letter is a guarantee of success.

For more questions or more sample letters, contact your Beds by George rep.