Does Medicare cover and reimburse for the SpaceOAR Hydrogel procedure?

Yes, currently all Medicare Administrative Contractor’s (MACs), cover and reimburse for the SpaceOAR Hydrogel procedure.

How can I find out if my insurance company will cover the SpaceOAR Hydrogel procedure?

Boston Scientific’s Benefits Verification and Pre-Authorization Team can confirm if SpaceOAR Hydrogel is considered a covered procedure and if a preauthorization is required by your insurance carrier, and verify any out of pocket costs associated. Please contact your physician’s office to work with our benefits verification team prior to scheduling your SpaceOAR Hydrogel procedure.

Is there a financial assistance program available for SpaceOAR Hydrogel?

Unfortunately, there are no formal financial assistance programs available for the SpaceOAR Hydrogel procedure through Boston Scientific.

What if my health insurance company has denied coverage for the SpaceOAR Hydrogel procedure?

Please work with your physician’s office to contact Boston Scientific’s Benefits and Pre-Authorization Team.

My health plan does not consider SpaceOAR Hydrogel as medically necessary. What can I do as a patient?

If your health insurance company has denied coverage for the SpaceOAR Hydrogel procedure, we recommend appealing the decision;

1. Contact your health plan directly and request a copy of the denial letter. After careful review of your appeal rights, you may use the enclosed letter of medical necessity template and submit a formal appeal directly to your insurance plan, or;
2. You may work with your physician’s office on submitting your denial to Boston Scientific Benefits and Pre-Authorization team for support.
3. If you are enrolled in an employer-sponsored health plan, this guide and sample appeal letter may be helpful as you pursue coverage.

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