Your Insurance: Other Non-Government Plans
About 50% of other non-government plans are covering lipedema. Smaller plans are likely to embrace covering lipedema as more members apply for coverage. If you have one of these plans, coverlipedema.com gives you the tools to argue that these smaller plans should follow the lead of larger plans and cover lipedema quickly and fairly. Because these plans have less members they are less concerned that they will have.
In many cases, your employer also may contract with a company that uses a large plan network but makes its own decisions. There is be more flexibility to argue for coverage and in many cases the employer’s benefits department has been supportive of coverage. Many smaller plans will cover skin excisions along with liposuction in most cases unless your plan policy has limitations on reconstructive surgery.
We still recommend that you allow at least four months to get covered. In some cases you can get reimbursement after surgery but many plans will enter into single case agreements with out-of-network providers so you only need to pay in-network copays and deductibles.
If it is necessary to appeal for coverage or fair payment, Coverlipedema.com has template appeal documents for members that is easy to work with and continually updated with the latest coverage and payment arguments. We also provide essential strategies and a database to ensure a fair external review and have even had final reviews reopened for poor quality.
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