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UVB Home Phototherapy Equipment for Psoriasis, Vitiligo & Eczema
Tips for Insurance Reimbursement - Canada
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Experience has shown that most health insurance companies will cover some or all of the cost of home UVB phototherapy equipment;
however, often this requires considerable persistence by the applicant.
To have the best chance of reimbursement, our suggestions are:
- Obtain Solarc's
Standard Information Package (SIP) for home phototherapy.
This is best done as a download from the above link, or as individual files from the
Download Centre.
We suggest at least two (2) copies; one for your insurance company and one for your records.
A third copy may be useful to leave with your physician.
If you are having trouble downloading, give us a call or use the
Contact Us
page to request that an information package be mailed to you.
We will make sure you get what you need.
- Obtain a prescription from your physician indicating as a minimum the device family and waveband type.
(UVB-Narrowband or UVB-Broadband)
For example: "UVB-Narrowband Full Body Panel",
or "Solarc/SolRx 1000 Series UVB-Narrowband".
On request, Solarc can provide the physician any additional information required,
such as copy of the appropriate SolRx Users Manual.
- Supply your physician with a copy of our
Doctor's Letter of Medical Necessity
and ask if they have time to create a personalized version of this for you on their stationery,
or have them simply fill in the blanks in the form.
There may be a cost for this.
You may wish to provide your physician with the above editable MS-Word (.doc) file on disc for their convenience.
- If you cannot get your physician to create the letter,
we recommend that you write your own personalized letter to your company's
human resources department or insurance company using our
Patient’s Letter to Insurance Company template.
This is an editable MS-Word (.doc) file that you can easily personalize.
This is your opportunity to make a "business case" for acquiring the equipment.
In other words, based on your usage of drugs and other costs, will the equipment pay for itself?
To support your case, include a copy of the medical study:
"Are Narrow-band Ultraviolet B Home Units a Viable Option for Continuous or Maintenance Therapy of Photoresponsive Skin Diseases?" (pdf)
- Talk to your human resources or insurer contact person about your request
and present them with copies of your prescription,
letter and all of the information literature. Ask for their help with your request.
Contact Solarc if your insurer requires submission of an invoice before they will consider coverage
(Proforma invoice).
- Depending on insurance company,
the first response to your request may be that the equipment is not covered.
The reason for this is that the first line contact person is normally only supplied with a list of commonly insured equipment,
and UVB phototherapy equipment is often not listed.
It might be helpful to mention that home phototherapy equipment is on the list of
medical expense tax credit
eligible expenses.
- At this point, talk to your contact person again,
and politely ask that your request be forwarded to a more senior representative.
Try to talk directly with this more senior person.
Some insurance companies will have an "appeal" process.
Many people have made successful appeals.
- Here is the key: Be persistent with your request and ask that it be referred even higher up if necessary.
Be patient and always polite. At some point the answer may be a definitive "no",
but in many cases, the Insurer will comply.
Your persistence shows that this is very important to you and that you truly need the device.
- Once approved, and just in case there is a change in personnel at the insurance company,
try to get the insurer’s commitment in writing…. Good Luck!
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Physician approval / prescription is required for all ultraviolet phototherapy device or UV bulb orders.
Solarc Systems Inc., 12 Parker Court, Barrie, ON, Canada L4N 2A6
Toll Free: 1.866.813.3357 Tel: 705.739.8279 Fax 705.739.9684
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