Insurance Coverage
Will Insurance Cover a Biomat?
Many customers wonder if a Biomat can be covered under their health insurance and the good new is that many insurance companies are starting to include medical devices like infrared therapy mats and will pay a portion or even all of the cost. In our experience, personal injury protection, flex spending accounts, and workman's comp claims tend to be the most likely solutions, but more and more, traditional insurance policies are also including devices like the Biomat.
Many in America and other countries in the West are beginning to understand that Western medicine is ruled by the pharmaceutical companies, and that it doesn't always include therapies and treatments that work without drugs. Western medicine, for the most part, looks to "plug the boat" when it comes to healthcare, addressing symptoms before actual problems with our health. For thousands of years, Eastern medicine has endevored to "fix the boat" instead of just plugging it. It looks to get at the core issues and not just treat the symptoms. Due to the dawn of this new understanding, demand for products like the Biomat have increased in recent years and insurance companies are beginning to take notice, often offering partial or full payment for medical devices that manage pain and stress, detoxify the body, and improve the immunce system.
However, that process of understanding is still ongoing and when it comes to getting a Biomat covered by insurance, every insurance company and policy is different, so there is no way for us to know if your particular policy will cover the cost. All we can do is give you our experience and best advice.
The Biomat is FDA-Approved
Remember that the Biomat is FDA-approved. This should help because insurance companies do not typically approve ANY treatment that isn't FDA-approved. The Richway Biomat is approved for temporary relief of minor muscle and joint pain, stiffness, arthritis-related pain, muscle spasms, sprains, strains, muscular back pain, muscle relaxation, and temporary increase of local circulation.
Steps for Getting a Biomat Covered by Insurance:
- Get a Prescription - See your doctor. Discuss the possibility of integrating far infrared heat therapy into your healthcare regimen and if your doctor sees no reason why it would hurt your treatment or thinks it might help, ask them for a prescription.
- Ask Your Doctor For a Letter of Medical Necessity - a prescription usually only has an RX number or code for the device, it does not tell the insurance company why your doctor thinks its necessary for your treatment and insurance companies will not cover a medical device if it is not necessary. All doctors are aware of what a Letter of Medical Necessity is for this reason and if they are willing to write the prescription, they should be more than willing to write a letter, on their letterhead, that states exactly why they think the Biomat is necessary for your health. Having this letter is imperative if you want the best chance to get coverage.
- Biomat Information - In our experience, most insurance companies are well aware of what infrared therapy is but they may not know about Biomats. So we suggest that when you turn in your documents to your insurance, that you include a couple pages printed from our website so that they cannot deny your claim purely because they don't know of the product. We suggest the following pages: How the Biomat Works, Biomat Certifications, and Health Benefits of the Biomat. If your claims adjuster wants to do research on their own, give them the name of the product and tell them to also search terms like "infrared heat therapy", "thermotherapy", "infrared therapy mats", and "infrared heating pads".
- Claim Paperwork - Your insurance company will have forms you need to fill out for your claim. Make sure you fill these out completely and accurately.
Once you have the above-mentioned documents in order, you have a decision to make. Normally, when a doctor writes a prescription for a drug, it is submitted to a pharmacy with your insurance information and the insurance company reimburses the pharmacy. It doesn't work that way with out of network medical devices. We've found most that get their Biomats covered successfully have purchased their Biomat up front and submit their invoice with the above-mentioned documentation. This proves to the insurance company that the money they give you has already been spent on the device you are asking them to approve. Most insurance companies will not approve coverage for a Biomat if they are not sure you will use the money for that purpose. So you're much liklier to be approve if they can see you have already done so.
However, by paying up front, you are accepting the fact that your insurance company may not approve it or only some of it and then you will be responsible for the rest. So you have to ask yourself, "Do I want or need the Biomat whether insurance pays for it or not?" If the answer is yes, then go ahead and order, get your invoice (receipt) and then submit your paperwork. The only alternative is to submit your paperwork without the invoice and then wait and see if your insurance will cover it. You could call them to get it pre-approved, but a lot of insurance companies don't work that way.
Information Your Insurance Company May Require
Below is a list of CPT codes and other information that your insurance company may require. We suggest you print this information and also take it to your doctor when asking for a prescription. This will help your doctor identify the product and when they are writing your Letter of Medical Necessity.
Important Insurance Information | CPT Code, HCPCS Code, or Number |
510K Number | K072534 |
Richway NPI Number | 1437589793 |
FDA Medical Device Registration Number | 2954299 |
USFDA Medical Device Code for Biomat | 890.5740 |
USFDA Medical Device Code for Alkal Life | 300505378 |
Health Canada License Number | 100137 |
Infrared Heating Pad System HCPCS Code | E0221 |
Materials & Supplies - Far Infrared Therapy Pad as equipment CPT Code | 99070 |
Medicine: Application of a modality to one or more areas; infrared CPT Code | 97026 |
Medicine: Application of a modality to one or more areas; contrast baths, each 15 minutes CPT Code | 97034 |
Hypothermia CPT Code | 77600 |