Tips to Help You Secure Reimbursement for Your Pelvic Health Treatment
Yes, It’s Possible to Pay Yourself Back for Out-of-Pocket Healthcare Expenses!
Ease the stress of paying for treatment by learning the secrets to getting your insurance to cover the costs.
Milli: The Only Expanding Vaginal Dilator Available Over-the-Counter—Here’s How to Get Reimbursed
While insurance doesn’t automatically cover the cost of Milli (whether through Medicare or private insurance), there are several potential pathways to reimbursement.
The key to successful healthcare reimbursement? Navigating the paperwork! But don’t worry—Milli is here to support you through each step of the process.
Table of Contents
How to Submit a Manual Claim to Your Insurance Plan
Good News: Milli is an FSA/HSA Eligible Expense!
You can use your flexible spending account (FSA) or health savings account (HSA) to save money on your Milli purchase, covering out-of-pocket expenses tax-free. Here’s what you’ll need to qualify for reimbursement:
- Purchase Receipt: You’ll receive an emailed receipt after buying your Milli dilator.
- Letter of Medical Necessity (LMN): Some insurance plans require a letter explaining why an expanding vaginal dilator is part of your treatment plan. Milli offers easy-to-use LMN templates tailored for different situations, so your clinician can quickly complete the necessary paperwork.
- Superbill: If you’re using an out-of-network, cash-only provider, they’ll give you a superbill with details on all services and payments.
Gathering the right documentation, including a compelling LMN and superbill, is well worth the time for the potential savings.
How to Submit a Manual Claim to Your Insurance Plan
Usually, claims for medical appointments are submitted electronically by your clinician’s office. However, there are times when a manual claim submission is needed, and this is one of those times. Although we can’t guarantee payment, it’s worth a try because you deserve coverage for your medical condition.
Visit Your Insurance Plan Portal (Medicare or Private Insurance) and search for a claim form, download it, and fill it out.
Submit the letter of medical necessity and superbill from your clinician with the Milli purchase receipt.
You deserve coverage for this legitimate medical condition, so tell the insurer why they should reimburse you.
Letter of Medical Necessity (LMN) Explained
Gathering the documentation, including a compelling LMN, is worth your time. This letter explains the reasons for the pelvic pain from insertion or penetration and includes a complete treatment plan. This detail can support reimbursement for all associated costs.
Descriptions of Common Experiences
- pain during pelvic exams with a speculum that interferes with your ability to obtain preventative care
- painful sex related to vaginal muscle tightness (vaginismus)
Pelvic pain from insertion or penetration can have multiple causes.
Each person’s experience with vaginal tightness is unique. As a result, in addition to the Milli expanding vaginal dilator, you might also need:
- Psychosexual therapy
- Relaxation and mindfulness
- Pelvic floor therapy
- Sensate Focus
- Hormone (replacement) therapy
Learn more about Flexible Spending and Health Savings Accounts here:
Need help planning healthcare expenses? The US Federal Government provides a free calculator.
Health Care FSA Savings Calculator – FSAFEDS
Superbills explained
Superbills are useful when you see specialist healthcare providers who do not accept insurance (e.g., out-of-network or cash-only). This document helps streamline the reimbursement process and help you potentially recover some of your healthcare costs. A superbill is a detailed receipt, and here’s how it works:
- Payment: you pay the healthcare provider directly after receiving treatment.
- Superbill Issuance: your provider gives you a superbill, which includes essential information such as diagnosis codes, procedure codes, the cost of services, and provider details.
- Insurance Reimbursement: You submit this superbill to your insurance company to request reimbursement for the out-of-pocket expenses, which are determined by out-of-network insurance plan benefits.