Insurance

Nell’s has been approved as an In-Network provider with:

AARP
ForwardHealth
Humana
Medicare
Network Health
Robin HealthPartners
Trilogy Heath Solutions
UMR
United Healthcare
WPS Health Insurance, Health Plan

General Insurance Information:

If we are billing your prescribed items, please bring the following to your scheduled consultation:

  • Current Prescription for billable items – can be faxed to (920) 393-4913

  • Current insurance card(s)

  • Complete a recent Face-to-Face with your prescribing Physician

HIPAA Notice of Privacy Practices (PDF)

Please arrive at least 15 minutes early to complete the registration process.

Nell’s has been approved as an In-Network provider with:

Billable items MAY include:

  • Mastectomy Bras

  • Post Surgery Garments with Mastectomy Forms

  • Silicone or Equal Breast Prosthesis

  • Foam Breast Prosthesis

  • Prosthetic Nipple

  • Cranial Prosthetic (Wig)

Please contact your insurance to see if these items are covered under your plan.

Medicare allowable items include:

One Silicone Breast Form – Every 2 years (2 forms for bilateral surgery)

-OR-

One Foam Breast Form – Every 6 months (2 forms for bilateral surgery)

-AND-

Mastectomy Bras are reimbursed as deemed Reasonable and Necessary

*Medicare is Primary

In order to qualify for partial Medicare reimbursement, a licensed practitioner and eligible to order breast prostheses must prescribe the items you are ordering. You also must complete a face-to-face meeting with your prescribing physician within 6 months of purchasing the items.

Nell’s will file your claim if we are in network with your insurance company, however, Nell’s may not be able to file a claim for Medicare Advantage Plans if we are not in network with the company. (i.e. HMO, Aetna, BCBS, Cigna, Molina, etc.) Check your benefits and local providers.

Supplemental/Secondary Insurance:

You may be eligible for additional coverage and/or reimbursement. Please bring your card along at time of appointment.