If you or your patients have a Medicare Advantage plan and have been denied coverage, or found that there is no in-network supplier with your/their plan, we need to hear from you!
Please use our Denial Reporting Form to tell us
what obstacles you/they have encountered.
Medicare Advantage plans are required by law to cover anything that traditional Medicare does, so if you or your patients are being denied coverage, or if the plan is unable to provide an in-network supplier, thereby making it impossible to utilize the coverage, we need to know!
Please note, however, as previously shared, although Medicare Advantage must now cover lymphedema compression supplies, they do not have to do so on the same terms as traditional Medicare, and each Medicare Advantage plan may differ. Meaning, the allowable quantities, replacement frequencies, and other details of the coverage could be different, and this does not constitute a denial of coverage.
We are working with the Centers for Medicare and Medicaid Services (CMS) to ensure that Medicare Advantage plans provide the required coverage. We know through the denial reports we have already received that some are not.
Because there are thousands of different Medicare Advantage plans, managed by hundreds of different insurance companies, it’s important that we hear from anyone who is not receiving coverage, so we can be sure that all plans are properly complying with the new law.
Thank you for your continued engagement!
Heather Ferguson
Founder & Executive Director
Lymphedema Advocacy Group
LymphedemaTreatmentAct.org
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