Now Available Medicare Coverage for Lymphedema in San Diego! : Get your Lymphedema items through Medicare Health Insurance

Now Available Medicare Coverage for Lymphedema in San Diego! : Get your Lymphedema items through Medicare Health Insurance
por Nicola Rodney-Crook en June 12, 2024

Medicare Coverage for Lymphedema Products: A New Dawn for Patient Care

Starting January 1, 2024, a significant change has come into effect for those managing lymphedema: Medicare now covers lymphedema products for patients with Medicare Part B who meet specific criteria. This is all thanks to the Lymphedema Treatment Act, a pivotal law that marks a new era in lymphedema care. In this blog post, we'll explore what this means for patients, what items are covered, and how you can take advantage of these benefits. If you need lymphedema compression garments in San Diego, our specialists at Bras and Honey Lingerie are here to help. We offer top brands and provide both ready-made and custom options to meet your specific needs.

What’s Covered?

Medicare now pays for both standard and custom-fitted lymphedema compression treatment items for each affected body part. This includes:

  • Compression Garments: Daytime and nighttime garments, which offer various levels of compression.
  • Compression Bandaging Systems and Supplies: Essential for the initial decongestion and maintenance phases of treatment.
  • Gradient Compression Wraps: Wraps with adjustable straps.
  • Necessary Accessories:
    • Aids for donning and doffing, such as lower limb butlers or foot slippers.
    • Fillers, lining, padding, and zippers to ensure optimal fit and function.

How Often?

Medicare covers compression garments and accessories at the following frequencies:

  • Daytime Garments: 3 garments per affected body part every 6 months.
  • Nighttime Garments: 2 garments per affected body part every 2 years.
  • Additionally, Medicare will pay for replacements if items are lost, stolen, irreparably damaged, or if the patient’s condition changes (e.g., changes in limb size).

Who’s Eligible?

To qualify for Medicare coverage of these treatment items, the following conditions must be met:

  • The patient must have Medicare Part B coverage.
  • The patient must have a diagnosis of lymphedema and use the item primarily and customarily to treat it.
  • The item must be prescribed by an authorized practitioner.

Your Responsibilities

When providing a lymphedema compression treatment item, you are responsible for:

  • Taking measurements of the patient’s affected body area.
  • Performing necessary fitting services.
  • Training the patient on how to put on and take off the treatment item.
  • Educating the patient on how to care for the item.
  • Adjusting the treatment item as needed.

The Impact of the Lymphedema Treatment Act

The Lymphedema Treatment Act, passed by the U.S. Congress in December 2022, represents nearly a decade of advocacy and effort by the lymphedema community. This legislation has created a new benefit category within Medicare, providing significant relief for patients who previously faced out-of-pocket expenses for necessary compression garments.

Lymphedema, which often develops after cancer treatments that remove or damage lymph nodes, affects an estimated 3 to 5 million people, with 1.5 to 3 million being Medicare beneficiaries. For breast cancer patients, lymphedema is commonly associated with axillary lymph node surgery and radiation therapy.

Addressing Disparities in Lymphedema Care

Data shows that some communities are disproportionately impacted by lymphedema. For example, Black women are three and a half times more likely than white women to develop breast cancer-related lymphedema. The new Medicare coverage aims to reduce these disparities by making essential compression treatment more accessible.

How to Access Covered Items

To take advantage of the new Medicare coverage for lymphedema products, follow these steps:

  1. Consult with Your Healthcare Provider: Discuss your condition and treatment needs with your doctor or a certified lymphedema therapist.
  2. Obtain a Prescription: Ensure that your healthcare provider prescribes the necessary compression items.
  3. Visit a Certified Fitter: Have your compression garments fitted by a certified fitter to ensure the correct amount of compression and proper fit.

Contact Us for Custom Compression Garments in San Diego

If you need lymphedema compression garments in San Diego, our specialists at Bras and Honey Lingerie are here to help. We offer top brands and provide both ready-made and custom options to meet your specific needs.

For personalized assistance and to find the perfect garment for you, contact us today!

Coverage Criteria Recap

Medicare will reimburse for lymphedema garments and supplies when:

  • The patient has Medicare Part B and a diagnosis of lymphedema.
  • The garment or wrap is ordered by a physician.
  • The garment or wrap is being utilized to treat lymphedema symptoms.

Items Covered Recap

Medicare will cover:

  • Standard and custom-fitted compression garments for daytime or nighttime management.
  • Compression bandaging systems and supplies.
  • Gradient compression wraps with adjustable straps.
  • Accessories such as fillers, lining, padding, and zippers.
  • Aids for donning/doffing garments.

Frequency Recap

  • Daytime Garments: 3 every 6 months.
  • Nighttime Garments: 2 every 2 years.
  • Additional Items: As needed for changes in condition or replacement of lost/stolen/damaged items.

For more detailed information about Medicare coverage for lymphedema products, please visit our website page about the Lymphedema Treatment Act. This new coverage is a significant step forward in reducing the financial burden on patients and improving access to essential treatments.

If you need lymphedema compression garments in San Diego, our specialists at Bras and Honey Lingerie are here to help. We offer top brands and provide both ready-made and custom options to meet your specific needs. We are also contracted to all the major healthcare providers including Medicare, Kaiser, Blue Shield, Aetna, United Healthcare, Tricare and Many more. 

Please note: Our compression specialists are not medical professionals and can only provide guidance on the fit of compression garments. For a comprehensive assessment, consult a fitter, doctor, or therapist who can compare multiple brands and find the garment that will help you achieve optimal results.

RECENT POSTS

Now Available Medicare Coverage for Lymphedema in San Diego! : Get your Lymphedema items through Medicare Health Insurance

Post-Mastectomy Prosthesis: Understanding Your Options

The choice to use a prosthesis is entirely yours. Many medical providers recommend breast forms because their weight helps improve posture, prevent shoulder drop, relieve neck and back pain and address balance issues

What to Expect from a Certified Mastectomy Fitter in San Diego

Bras After Surgery for Breast Cancer | What To Know About Mastectomy Bras

BRA FIT GUIDE: HOW TO FIND YOUR PERFECT BRA IN SAN DIEGO

The undergarments you wear should never interfere with your day-to-day activities—in fact, they should fit so comfortably that you forget you're even wearing them. If that sounds impossible, there's a good chance you haven't been wearing the right size. Fortunately, learning how to measure your bra size doesn't take long.

TAGS

DEJA UN COMENTARIO

Los comentarios deben ser aprobados antes de aparecer


VOLVER ARRIBA
We use cookies to ensure that we give you the best experience on our website. If you continue we'll assume that you are understand this. Learn more
Accept