Are TheraTogs covered by insurance, Medicare, or Medicaid?
Many state Medicaid programs, and an increasing number of private payors, are accepting reimbursement claims for TheraTogs based on either miscellaneous or product-specific orthotics codes (the “L” code series of the HCPCS system). The key factors in the decision are the specific coverages provided by your particular insurance benefit package, and the medical necessity you can demonstrate in support of your claim. Start by reviewing your insurance benefits literature or call your carrier to see what coverage is provided for orthotics or durable medical equipment – and note that it is always best to check with your insurance company about coverage issues before product purchases are made. This will not only avoid unexpected out-of-pocket expenses; your insurance company can also inform you of criteria or forms needed to file the claim. Knowing what you need on the front end will help avoid long delays in being reimbursed. Your best bet is to document the needs that TheraTogs addresses,
