When it comes to pediatric orthotics, insurance coverage can be a tricky area. Generally, most insurance plans do not cover custom orthotic devices. However, many families find that Flexible Spending Accounts (FSA) or Health Savings Accounts (HSA) can be used to help with the cost. These accounts allow you to use pre-tax dollars to cover medical expenses, including orthotics like the Mikki Device, Andy Device, or Toe Walking Brace.
It’s always important to check with your insurance provider directly to confirm if your plan covers these products. Some providers may classify pediatric orthotics as durable medical equipment (DME), which might open a path to partial coverage if medically necessary.
Why Paying Out-of-Pocket May Save You Money
Surprisingly, purchasing pediatric orthotics directly, without insurance, can often be more affordable. Insurance claims for similar treatments may come with high premiums, deductibles, or co-pays, which can significantly increase your overall costs. By opting to pay out-of-pocket, you avoid these additional fees, and many providers offer lower prices for direct purchases.
Using FSA and HSA for Orthotics
Both FSA and HSA accounts offer a tax-advantaged way to pay for medical expenses that insurance doesn’t cover. Pediatric orthotics are generally eligible expenses under these accounts, meaning you can purchase devices like the Mikki Device (for Sever’s disease), Andy Device (for flat feet), or the Toe Walking Brace (for toe walking correction) using your FSA or HSA funds. These accounts provide a flexible and accessible way for families to afford essential orthotic devices without the hassle of dealing with insurance claims.
What About Different Insurance Carriers?
Insurance policies vary widely across carriers, so it’s essential to review your plan’s specific terms. Some insurers may offer partial coverage, particularly if the orthotic device is prescribed by a doctor as part of a treatment plan for a diagnosed medical condition. Common carriers, such as Blue Cross Blue Shield, Aetna, or UnitedHealthcare, may require prior authorization or specific medical necessity documentation for orthotics coverage.
Conclusion
While insurance may not typically cover pediatric orthotics, using FSA or HSA accounts can offer significant savings for families. Additionally, paying out-of-pocket for devices like the Mikki Device, Andy Device, or Toe Walking Brace. is often more affordable than going through insurance.
Also, by understanding your insurance plan and exploring alternative payment options, you can ensure your child receives the best care without unnecessary financial strain.
