Insurance & Billing
We accept Medicare Part B and most major insurance plans. Learn how your coverage works for regenerative wound care treatments.
If you have Original Medicare Part B (the standard Medicare plan), you have excellent coverage for our advanced regenerative wound care treatments. Medicare Part B covers medically necessary wound care services, including:
Comprehensive wound assessments and evaluations
Advanced debridement procedures
Regenerative tissue therapies
Specialized dressing applications
Negative pressure wound therapy (NPWT)
Follow-up visits and ongoing management
Medicare Part B provides comprehensive coverage for advanced wound care treatments without the restrictions often found in Medicare Advantage plans. Most of our patients with Original Medicare Part B experience smooth approval and coverage for their treatments.
Medicare Advantage (also called Medicare Part C or "MA Plans") are offered by private insurance companies approved by Medicare. While these plans can offer additional benefits, they often have different coverage rules and restrictions for advanced wound care treatments.
Medicare Advantage plans may require prior authorization for advanced treatments, have network restrictions, or deny coverage for certain regenerative therapies that Medicare Part B typically covers. Each Advantage plan has its own rules and approval process.
Many Advantage plans require approval before treatment, which can delay care
You may need to use specific providers or get referrals
Some advanced regenerative therapies may not be covered by your specific plan
Coverage differs significantly between Advantage plan carriers and specific plans
If you have a Medicare Advantage plan, we'll work with you to verify coverage and pursue authorization. However, please be aware that some treatments may not be approved. We recommend contacting your plan directly to understand your wound care benefits before your first visit.
If you have Original Medicare Part B with a Medicare Supplement (Medigap) policy, you typically have excellent coverage. Medigap plans work alongside Medicare Part B to cover copays and deductibles.
This combination typically provides the best coverage for advanced wound care. Medigap helps pay the 20% coinsurance after Medicare Part B covers 80%.
Some supplemental insurance plans have restrictions on what they cover, especially for advanced or regenerative treatments. Coverage varies by carrier and policy.
If you have a supplemental insurance plan (not Medigap) or secondary insurance, coverage for advanced wound care treatments can vary significantly. Some plans may:
We work with most major private insurance carriers. Coverage for wound care varies by plan, so we recommend verifying your benefits before treatment.
We accept select Medicaid plans. Coverage varies significantly by state and specific Medicaid program. Please contact us to verify if we accept your Medicaid plan.
Note: Medicaid coverage rules differ from Medicare, and some advanced treatments may require special approval.
We honor our veterans. If you have VA benefits or TRICARE coverage, we'll work with you to coordinate care and explore coverage options.
Call to discuss your benefitsIf you don't have insurance coverage or prefer to pay out-of-pocket, we offer transparent self-pay pricing. Contact us for a cost estimate based on your specific treatment needs.
Payment plans may be available for qualifying patients.
If your insurance denies coverage, we'll work with you to appeal the decision and provide supporting clinical documentation. We can also discuss alternative treatment options or self-pay arrangements if needed.
Our goal is to ensure you receive the care you need while working within your coverage limits.
Medicare Part B: No referral required. You can schedule directly with us.
Medicare Advantage & Other Plans: Many plans require a referral. Check your plan details or contact us for help determining if you need one.
Out-of-pocket costs vary based on your specific insurance plan, deductible status, and coinsurance amounts. For Medicare Part B, patients typically pay 20% of the Medicare-approved amount after meeting their annual deductible.
We'll provide a cost estimate after verifying your benefits. Contact our billing team at 877-545-1300 with questions about costs.
Yes, you can switch during specific enrollment periods (typically October 15 - December 7 for the Annual Enrollment Period, or January 1 - March 31 for the Medicare Advantage Open Enrollment Period).
If you're experiencing coverage issues with your Medicare Advantage plan, switching back to Original Medicare Part B may provide better access to advanced wound care treatments. Contact Medicare at 1-800-MEDICARE to discuss your options.
Our billing team is here to help you understand your coverage and answer any questions about insurance or costs.
Our billing specialists are available Monday-Friday, 8:00 AM - 5:00 PM