With the passing of the Lymphedema Treatment Act, Medicare now covers compression garments for patients who have been diagnosed and treated by a therapist for lymphedema. Most private insurance carriers now cover up to three (3) daytime compression garments every six months, and two (2) nighttime per year. In order for insurance to authorize and pay for garments they require three things:

1. A detailed prescription dated within one year “Generic” prescriptions stating only “compression garment” are no longer acceptable.
2. Progress notes from your medical record that describe the treatment you have received for lymphedema, also dated within one year.
3. The products you wish to order, including brand, size, color choice or a measurement form from your therapist if you require custom garments.

These requirements mean that you must be treated annually for lymphedema if you want to use insurance to cover your products. If you do not have the required clinical documentation you will need to see your Lymphedema Therapist for them to provide your progress notes, choose the appropriate garments for you, and measure you for the correct sizing. Your therapist can then place your order via our therapist portal at www.SunMEDExpress.com or with their dedicated SunMED Customer Care representative.

If you do not have a therapist or the documentation insurance orders require you can purchase your products here and submit for reimbursement yourself or use FSA or HSA funds.  SunMED cannot tell you what your insurance will reimburse you directly.

If you have been seen by a therapist in the past year and possess the documentation your insurance requires you can start your order here and upload a current RX, your progress notes, and the products you would like. If they are complete, we will submit them for authorization with your insurance company and if approved will send you a secure payment link if your plan requires a co-pay.