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Insurance + Medicaid Guide

Ready to ensure your loved one's safety with a Cubby Bed? Our step-by-step video breaks down the insurance process, making it easier to understand and navigate.

Cubby Beds have many benefits for sleep, safety, and sensory regulation, however, insurance typically only reimburses a safety bed for significant safety concerns such as elopement, fall risk, self injury, seizures or other well documented behaviors that could cause injury. If your loved one may qualify, follow the steps below and be sure to download the Insurance Packet to provide to your doctor.

1) Schedule a Doctor’s Appointment

It's great that you're taking the first step to ensure your loved one's safety and well-being! The purpose of this visit with your primary care doctor is to get a prescription and letter of medical necessity for a Cubby Bed. Focus on your child’s safety concerns and clearly communicate why a Cubby Bed is medically necessary for your loved one and why other solutions have not worked in the past. If you have an occupational or physical therapist (OT/PT), we encourage them to write your letter of medical necessity. However, if you do not have an OT/PT, a letter from your primary doctor is just fine.

2) Get a Prescription

After discussing your loved one's needs with your doctor, ask for a prescription for a "Cubby Safety Bed." We've put together a packet of Required Documents to help guide you through this step. It includes everything your healthcare provider needs, from detailed instructions to a prescription form. Take a moment to go through it and then share it with your doctor.

3) Get a Letter of Medical Necessity

Now, let's talk about getting a Letter of Medical Necessity (LMN). This letter, written by healthcare professionals like your doctor or occupational therapist (OT), explains exactly why your child needs a Cubby Bed. It should detail your child's specific safety concerns, previous attempts at solutions, and why the Cubby Bed is the best option. A complete guide to LMNs can be found here.

1) Find a Supplier (DME)

To find a Durable Medical Equipment (DME) Supplier, utilize our Supplier Locator Map. It is a great resource to connect with a DME in your area. Confirm if they can supply the Cubby Bed, accept your insurance, and service your area. If you have trouble finding a DME in your area, reach out to us at hello@cubbybeds.com.

2) Finalize your Documents

You’ll work with your Durable Medical Equipment (DME) Supplier as they conduct a comprehensive review of all your documents, ensuring all required information is ready before submission to insurance. Proactively communicate with your DME, such as regular check-ins or status updates. You're making great progress—keep up the fantastic work!

Verify with your DME on whether your insurance accepts the Required Documents linked in Step 1 or if they require additional documents. Our packet gathers information only; ensure all equipment-specific documentation is provided in a practitioner’s chart note, therapist’s evaluation, or state Medicaid forms if applicable.

Please note we at Cubby Beds do not bill insurance and your medical documents will need to be sent to a Durable Medical Equipment (DME) Supplier by you or your primary care doctor.

1) DME submits claim to Insurance/Medicaid

Once your Durable Medical Equipment (DME) Supplier has all the necessary information, they will submit your claim and work directly with your insurance company to get your Cubby Bed approved according to your coverage benefits. This is a significant step toward getting your Cubby Bed approved and ensuring your loved one's safety. Depending on your insurance provider, location, and specific situation, the approval process can take some time. Be sure to follow up regularly on the status of your claim.

2) If approved, DME will order your bed

Exciting news! If your claim is approved, you're one step closer to safer sleep. Your Durable Medical Equipment (DME) Supplier will take care of the logistics, including delivery and assembly details. Stay in touch with them for updates on when you can expect your Cubby Bed to arrive. It won't be long now!

3) If denied, you can appeal

Don't lose hope if you receive a denial on your first try—it's more common than you think. Many families have successfully appealed and ultimately received approval for their Cubby Bed. To get started, review our Guide on Appeals and Denials and work closely with the Durable Medical Equipment (DME) Supplier to submit an appeal to maximize the chances of overturning the decision.

FAQs

The duration varies based on factors like your insurance provider, case complexity, and documentation completeness. Begin the process promptly to avoid delays.

Factors influencing the duration:

  • Insurance Policies: Each provider has different processing times and requirements.

  • Case Complexity: The intricacy of your case affects processing speed.

  • Documentation Completeness: Ensure all paperwork is complete to avoid delays.

  • Prior Authorization: Some plans require approval before providing equipment.

  • Appeals: If denied coverage, appeals can prolong the process.

Taking proactive steps:

Schedule a doctor's appointment to discuss your need for a Cubby Bed. While we can't provide an exact timeline, we're here to support you throughout.

The approval of a safety bed insurance claim depends on several factors, including:

  • Medical Necessity: Insurance companies typically require evidence that the safety bed is medically necessary for the individual's condition.

  • Policy Coverage: The extent of coverage for durable medical equipment, including safety beds, varies depending on your insurance policy.

  • Documentation: Comprehensive and accurate documentation from your healthcare provider supporting the need for a safety bed is crucial for claim approval.

  • Preauthorization Requirements: Some insurance providers may require preauthorization before approving coverage for a safety bed.

  • Network Providers: Using a DME supplier within your insurance provider's network can streamline the claims process and ensure compliance with their policies.

Once you have your LMN, we're here to help! Our in-house specialists offer a free service where they can review your letter and provide suggestions. It's just another way we're here to support you on this journey. You can access this service here.

Durable Medical Equipment (DME) Suppliers are here to lend a helping hand and make the process smoother for you. While we're the creators and manufacturers of the Cubby Bed, DMEs are experts in navigating insurance coverage, coordinating with healthcare providers, and ensuring a seamless delivery process.

Our Cubby Care Team is also here to support you. Simply fill out this form to request a document review by one of our specialists, who will offer recommendations or email us at hello@cubbybeds.com to learn about other funding options.

  • OT = Occupational Therapist
  • PT = Physical Therapist
  • RX = Prescription
  • LMN = Letter of Medical Necessity
  • DME = Durable Medical Equipment Supplier

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