Understanding what is and isn’t covered in a person’s insurance plan can feel as complicated as keeping up with tax codes that change every year.
And to make things even more complicated, every plan is unique to the person or family it covers — so what may be true for a fellow athlete may not be true for you.
So it’s no wonder that patients are often left scratching their heads wondering if a doctor-prescribed cold compression treatment plan will be covered. Even worse, some patients refuse treatment out of fear they will be buried with out-of-pocket expenses when something isn’t covered.
Unfortunately, the short answer is that insurance companies often do not cover cold compression therapy, even if it’s medically mandated. This is the case for many commercial insurance carriers, as well as Medicare plans.
Their reason that cold therapy is not on many insurance company’s fee schedule is that cold therapy devices don’t need to be prescribed — they can be purchased over the counter at a pharmacy, or directly on websites like ours.
The good news is that therapies like cold compression systems are gaining acceptance among insurance carriers, especially on Workers’ Comp claims. However, there’s still a long way to go until it is covered by most people’s insurance.
How to Determine if Your Insurance Covers Cold Compression Therapy
That being said, the best way to verify if your insurance will cover your cold compression treatment is to contact them directly.
You can ask your insurance company for a copy of your Summary of Benefits and Coverage (SBC), which will list the details of your coverage.
But you may need to call your insurance company to get an answer. You can call the number on your insurance card and speak to a representative directly.
To make this as painless as possible, here are some tips that Medicare Interactive recommends:
- Prepare for the call: Have all your documentation on hand, including your insurance policy number, your personal information, and details about the cold compression treatment you’ve been prescribed or would like to use.
- Write down the information you receive: Record any important information like the representative’s name, their extension, and any next steps they ask you to take.
- Send information immediately: If they do ask you to submit any info after the call, make sure to do this right away.
As we’ve said, chances are that you’ll get a “no.” But it doesn’t hurt to check! If your insurance doesn’t cover your treatment, you still have a few options to consider.
Solution 1: Cold Therapy Equipment Rental
Renting the equipment is one viable option that will lower your out-of-pocket expenses considerably.
Many people will rent the equipment from their therapist to enable them to continue the therapy at home, returning the equipment once healing is complete.
Companies that rent out cold therapy machines are becoming more and more popular. It’s harder, however, to find companies that rent out cold compression therapy devices. So you may want to consider purchasing the equipment for full benefits.
Solution 2: Purchasing Equipment
If insurance doesn’t cover your cold compression therapy, why not buy the equipment yourself? After all, some clients decide they want to own the equipment because they see the benefits to having cold compression therapy outside of their clinical sessions.
This can make the most sense when purchasing an affordable cold compression therapy device like PowerPlay’s single kit with compression pump, wraps, and ice gels. A one-time purchase can have long-lasting benefits and lower your costs over time, if you continue to use it regularly.
Get the Treatment You Need
After calling your insurance carrier, check back in with your doctor or physical therapist. They may be able to recommend affordable options for you, and in many cases they can create a payment plan so you can get the treatment you need. It’s also important to check in with them if you’re thinking of renting or buying equipment to support your treatment.
No matter your situation, there’s most likely an option that will fit your circumstances — and get you the healing you need. And if you have any questions about how PowerPlay’s cold compression products work, don’t hesitate to give us a call.