Positives and Negatives Regarding purchasing a portable tens or interferential pain machine out of pocket or having the insurance company buy it for you.
There are a variety of factors, both in support of and against, although the vast preponderance of the evidence does support using the insurance benefits that have already been paid for. There is little evidence to support “double paying”. Well before paying out of pocket, it will be important and vital to make sure you know and fully grasp these pros and cons. This article explains some of the important plusses and minuses associated with using insurance benefits versus paying out of pocket. It will be important to you to fully understand these so that you can be able to make the most effective final choice in your case.
Advantages: Points In Favor Of purchasing a portable tens or interferential pain machine out of pocket.
1. Generally the cash or credit card cost is less when insurance does not have to be processed.
The cost of billing can often double or triple the costs of a company supplying medical products. In the case of Medicare compliant billing, the company has several costs of producing paperwork with the physician office and the labor, submission costs can easily be over $70 per unit.
2. The device can be mailed or delivered to the home or office, whereas the traditional delivery method has been in the clinic or physician office.
If the unit is provided in the mail then the patient does not have to schedule an appointment, take time off and pay an office visit fee.
3. Consumer Refund Protection When Using Credit Card
Another good reason for paying out of pocket is if a credit card is used and the product is defective then there is consumer protection offered by the credit card company in case a refund is due yet the company will or did not stand behind their product. Credit card companies usually offer refunds and the patient is protected by the use of the credit card to purchase the tens or interferential unit
This provides the added advantage of dealing directly as the payor with the company, rather than the payor being an insurance company, that can make it difficult to request a refund when the refund would be issued to the insurance company and not the patient..
4. The patient chooses who to purchase from and not the insurance company.
Often the insurance company may dictate what, and from whom, the device may come from without regard to the instructions, service, and dependability of the company.
And then there is the issue of how long has the company been around and will they still be there if a problem arrives or supplies are needed. That is critical as it may happen that the patient is in need of assistance yet the company has folded. The patient’s insurance may now not cover a new unit since there was a provision within the contract permitting only 1 unit per year, or every 5 years, and even if a unit can be procured the process of getting approval can take forever, or it seems that way if the patient is in pain. Whenever you take that into mind, then it makes sense to use insurance benefits versus paying out of pocket. If the insurance company is not prompt then the option of out of pocket may make more sense.
The points above show the positive aspects of purchasing a portable tens or interferential pain machine out of pocket. There is a bad side too. Let us consider some of the negative aspects.
Negative Aspects: Arguments Against purchasing a portable tens or interferential pain machine out of pocket.
1. Most insurance policies provide for “durable medical equipment” which is what an interferential or tens unit is classified as.
The monthly premiums that were being paid entitles the patient to the reasonable costs for the unit. Any out of pocket costs are truly an “add on” to costs that were paid for and should be covered.
If you ever purchase a portable tens or interferential pain machine out of pocket, that might produce the effect of not having the supplies such as tens electrodes, batteries, tens replacement cables, rechargers, AC adaptors, not covered as there would be no record of the insurance company ever purchasing the unit therefore there will be no coverage for the tens supplies needed to maintain continual operation. There is no way that that could be a good thing. It could be enough reason for avoiding doing it at all.
2. The cost of ancillary supplies for chronic pain such as Tiger Balm patches, arnica patches, Sombra, BioFreeze, FlexAll, DMSO are not covered.
Those supplies are generally covered by insurance, including Medicare and some state agencies such as Medicaid, that are used for the condition the interferential or tens pain machine was prescribed for. This would also include skin care products in case the adhering electrodes cause some minor skin irritation to the patient.
3. The company that many insurance companies purchase from, especially Medicare and the state funds such as Medicaid, have to be ACHC accredited.
This means the companies have paid for, and been thoroughly inspected and accredited on issues such as patient privacy, patient rights, good manufacturing processes, compliance with regulations, and inspected to see that customer complaints and needs are adequately resolved. If the company is not accredited, or loses it’s accreditation, then Medicare and many other insurance companies will not approve any purchases from that company.
4. The last valid reason to avoid out of pocket payment for the pain machines is you are literally “double paying” for benefits already paid for.
Also the cost of the tens unit is really not the cost of the unit itself, but the cost of the supplies needed, and one forgoes the benefits of the tens accessories and skin cream products in the future. That out of pocket cost can be many times over the cost of the original unit. With tens and the possibility of constant use, versus interferential with short 20 – 40 minute treatments often weekly or every 2-4 weeks, the electrode costs alone can be exorbitant. Interferential electrodes are best if they are somewhat larger than the standard tens electrodes. With insurance the patient can have both types electrodes for use and not have to pay for them separately, especially when the unit purchased was a combination tens and interferential unit.
Everyone ought to think about this point very carefully, because it can cause undue financial hardships if you determine to pay out of pocket anyway.
That is it, the actual pluses and minuses of purchasing a portable tens or interferential pain machine out of pocket or having the insurance company buy it for you. So it may not be what everyone wants and needs. Even so it will suit and help many. It is best to now look at the points made above and choose if this is right for you. This info should really assist you to be ready for making the proper decision.