Insurance Coverage — InterStim Therapy
Cost
Coverage will be determined on a case-by-case basis. Your physician will submit a coverage request to your insurance company on your behalf prior to the procedure to determine if you are eligible for coverage.
It’s important to make sure you understand your coverage and any insurance provider requirements, including “prior approval.” Please note that Medicare does not require a prior approval process, but will need to be contacted by your doctor.
Approval Process
Typically, your doctor will work with you to get prior approval from your insurance company. He or she will send a letter of medical necessity explaining why InterStim® Therapy is right for you and confirming that more conservative treatments have been unsuccessful.
Sometimes insurance companies are unfamiliar with InterStim Therapy, and may turn down your initial request. Don’t be alarmed if this happens to you. Often, sending more information as part of an appeal can be helpful. Members of the Medtronic Coverage and Authorization Services Group will guide you and your doctor through the approval process.
The Medtronic Health Economic Group is another resource that can help with insurance coverage for neurostimulation.
Services of the Health Economic Group include:
- Education programs for individuals
- Information services to address specific coverage and payment questions
If you’ve been denied coverage or have questions, call Medtronic Coverage and Authorization Services toll-free at (800) 292-2903.
Information on this site should not be used as a substitute for talking with your doctor. Always talk with your doctor about diagnosis and treatment information.
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