How others have managed to have this product covered by their Health Insurance Carriers:
1. Begin the
Healing Process: Take the product for the first 60 to 120 days. (This needs to
be done first so that you will be able to honestly say that the product is
helping you, and so that you will have the invoices to prove that you are
taking it.)
If you are acting on your own:
2. Contact your doctor, describe your progress, and ask for a “Letter of Medical Necessity” for the product, signed by your doctor.
3. Contact your insurance carrier and ask for a contact person to communicate with. Fax or email the Letter of Medical Necessity to your carrier, along with any completed documentation they may require.
Note: It has been proven useful to include in your documentation, a list of the pharmaceutical drugs and their costs which you are avoiding by taking the natural product. When the insurance review agent can clearly see the savings to the insurance company, your chances of reimbursement are greatly increased. Most insurance companies do not view the product as expensive due to the fact that most prescription medications are many times the cost per month. See Questions and Disclaimer below.
Common Questions:
- Q: Why can’t I contact the insurance company first, see if they will cover it, then begin the healing process? A: Because natural products are generally not “approved” to be covered by insurance. If you submit the paperwork before being able to claim and show that you are taking it, and it is helping you, your request will likely be rejected. Once rejected, it may be difficult to have reversed.
- Q: Will or should my doctor help me with this? A: Although most MD’s are drug-oriented, as they have been trained by the drug industry, requests for Letters of Medical Necessity are almost always granted when the patient tells of progress and the financial need for insurance coverage.
- Q: Once I am approved for reimbursement from the insurance company, will they always reimburse me, or will I need to re-submit at a later date? A: In most cases, once you are approved, you are approved, but of course we cannot speak for all carriers and policies may change with any carrier at any time.
- Q:What is the average length of time it takes to get reimbursement from insurance? A: This time frame may vary widely from carrier to carrier.
Disclaimer: Please Note: Customers generally report reimbursements ranging from 50% to 100%. This information is not an offer of reimbursement from Pristine Nutraceuticals, nor is it to be construed as a guarantee of reimbursement from your insurance carrier. Reimbursements from insurance carriers are contingent upon the proper completion and filing of your insurance carrier’s paperwork and at the sole discretion of the carrier. Additionally, please note that Pristine is not involved with the process of reimbursement. The reimbursement process is between you and your insurance provider. This method reported and outlined here is a generalization of procedure reported. Your exact mode of action required by your carrier may vary. Questions call: 1-888-671-2873