Often individuals are attempting to obtain products or equipment to assist in their care and recovery of neurological issues. If the item is specified in your insurance policy, the process of using a prescription from your healthcare provider is all that is needed.
If a particular medical supply, equipment, or treatment is not covered, you may still be able to obtain your request through a letter of medical necessity. This letter is written by your healthcare professional with information specifically about your health situation, why the request is being made, how it will affect your health, and information about the product or treatment being requested.
The health insurance policy number or Medicaid number must be at the top of the letter. Also, the owner of the policy is needed, whether it is you, a spouse, a parent, a guardian, or another. The policy owner’s address is provided in this section with the policy number.
Most companies have sample letters of medical necessity that have been used successfully. Samples are often readily available on company websites or through company contact. These letters need to be individualized to your specific needs. Modifications that make the need specific to your health are required.
Your healthcare professional may already have used some sample letters of medical necessity, so they are familiar with how to obtain them, but providing copies to your health professional is always welcome. Many companies will work with your healthcare professional to create the best letter.