Does insurance cover a Hands Free Crutch?
d. All of the above
The correct answer is: d. All of the above
Every insurance company and every plan is different. For example, Blue Cross Blue Shield of Michigan's plan for the teachers union covers the full purchase price of a Knee Scooter. The BCBS small business plan does not cover knee scooter…or much else. Other plans may cover rental, but not purchase. Other plans are the exact opposite. There are so many companies and plans that you should not believe an answer about coverage from anyone but your insurance company.
To find out if YOUR insurance covers Crutch Alternatives call them.
What you will need before you call:
When you call the number on the back of your insurance cards you will need:
- The Code for Knee Scooters (HCPC E0118 - Crutch alternative)
- Your Diagnosis code which you MUST obtain from your doctor.
What is a Diagnosis Code also known as a Procedure Code (CPT)?
This code tells the insurance company what your doctor has identified as the injury or surgery for which you are being treated. You can get this directly from your doctors office. For example, your insurance company may cover a Knee Walker for CPT Code 727.6 Rupture, Achiles Tendon but not for CPT Code 30450 Rhinoplasty (Nose surgery). The code you provide MUST match the code used by the doctor or all claims could be delayed.
When you call you insurance company?
Make sure to document the name of the person you spoke with, the time and date of the discussion, and the answers to all three of these important questions:
- Is HCPCs Code E0118 (Crutch alternative with or with out wheels) a covered expense
- What is the coverage level (what dollar amount of percentage do they cover)
- Are there any other requirements (purchase verses rental, in network provider, etc.)
When you submit a claim?
Regardless of the answer from the insurance company, make sure to include a paid receipt, signed prescription and Letter of Medical Necesity for a Hands Free Crutch signed by your doctor when you submit your claim.
Your Right to Appeal?
It is your right to appeal the insurance company's decision. More commonly people can not find a Knee Scooter locally and end up having the in-network requirement waived. Even if your insurance company deems a Knee Walker a non-covered expense it may count towards your insurance deductible. Additionally check with your tax preparer as your Knee Walker may be able to be used as a medical expense on your tax return.