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Are Weighted Blankets Covered By Insurance?



SLEEP SCIENCE

Are Weighted Blankets Covered By Insurance?

7 minute read
wonderful weighted weaves girl in napper red

For some, weighted blankets may just be a cozy addition to their sleeping routine. For others, weighted blankets may be a medical necessity to help with a condition, ranging from anxiety to sensory processing disorder to restless leg syndrome. You may be wondering if weighted blankets are covered by insurance, and unfortunately, there’s no definitive answer to that question. The short version is: maybe! Keep reading to find out more about whether your weighted blanket may or may not be covered by your insurance. There are a lot of nuances to insurance policies in general, and the topic of weighted blanket coverage is no different.


What does medical insurance have to cover?


There are 10 essential health benefits that are covered by insurance plans, according to HealthCare.Gov. These include:

• Ambulatory patient services (outpatient care you get without being admitted to a hospital)

• Emergency services

• Hospitalization costs

• Pregnancy, maternity, and newborn care (both before and after birth)

• Mental health and substance use disorder services, including behavioral health treatment (this includes counseling and psychotherapy)

• Prescription drugs

• Rehabilitative and habilitative services and devices (services and devices to help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills)

• Laboratory services

• Preventive and wellness services and chronic disease management

• Pediatric services, including oral and vision care (adult dental and vision coverage aren’t essential health benefits)


Do weighted blankets make the list?


There are some categories that weighted blankets might fall under. For example, if you have severe insomnia or restless leg syndrome, a weighted blanket may be categorized as a habilitative medical device that helps with that chronic condition. If you have severe anxiety, the weighted blanket may be categorized under mental health services. Other mental health conditions that might be considered include depression, ADD/ADHD, or sensory processing disorder related to autism. Another example might be if you use your weighted blanket as a preventive wellness service. The category that it is gets placed under will be up to your doctor to decide how to code it, based on your condition.

However, all of this seems to be left up to interpretation, which is why the answer can vary case by case. Also, different states have different requirements and guidelines for what gets covered by insurance. Some insurance companies have allowed weighted blankets to be listed as medical devices, while others have not. Suffice to say, the answer also depends on what state you live in as well as your insurance provider.

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Did you know?
According to the Anxiety and Depression Association of America, a whopping 40 million American adults (18% of the population) have an anxiety disorder, and almost 40% of Americans are becoming more anxious. Yikes.


What else can I do?


Your best bet would be to get a prescription from your doctor stating why you need a weighted blanket. It might be necessary to have a specialist write the prescription, depending on the nature of your condition. Your doctor can help to make the case that the weighted blanket is a medical necessity for you. If you want to be proactive, you may want to bring your doctor some research studies about how weighted blankets help your specific condition. Remember that some doctors may not know the benefits of weighted blankets. Then, submit the claim through your insurance company. You can also give your insurance company a call, as talking to a real human can help your case sometimes. Who knows, maybe you’ll be patched thriough to an empathetic representative intent on getting you insurance. Hey, you never know...

If you are unable to pay the cost of a weighted blanket, you can try to have a durable medical equipment company purchase the blanket for you. Then, you can attempt to submit the invoice through your insurance company. While it’s not a slam dunk, it’s worth a shot!

You could also purchase the weighted blanket on your own and submit the bill for reimbursement directly to your insurance company after the fact. You may want to read the “Durable Medical Equipment” section of your insurance policy to see if it includes any relevant coverage details.

Lastly, when weighted blankets are considered medical devices, they can also be tax-deductible. Cha-ching!


Bearassentials

• Weighted blankets may be able to be categorized as a medical device or durable medical equipment, which would increase the likelihood that insurance companies would cover the cost.


• Every insurance policy differs as to what they will cover and how much of the cost they can absorb. The state you live in also plays a role in the matter, so it’s very hard to say for sure one way or the other.


• Getting your doctor or a specialist to write a prescription for you will increase your chances of being covered, since they can make the case that the weighted blanket is in fact a medical necessity for you.

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Did you know?
According to the Anxiety and Depression Association of America, a whopping 40 million American adults (18% of the population) have an anxiety disorder, and almost 40% of Americans are becoming more anxious. Yikes.



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