Do You Have Medicare Part B?

Elitone is approved for nationwide Medicare Part B coverage (also known as Original or Traditional Medicare) as Durable Medical Equipment (DME). Medicare covers Elitone as a rental for 13 months, after which ownership transfers to the patient. You will be responsible for any co-pays or out-of-pocket costs.

Requirements for Coverage:

  • Prescription (Rx) for Elitone or Elitone URGE, including a Medical Necessity Statement, also known as Detailed Written Order (DWO).
  • Physician documentation indicating a 4-weeks of pelvic floor muscle exercises attempted with additional intervention needed.
  • (Helpful, but not mandatory) Chart notes supporting the need for neuromuscular electrical stimulation before considering surgical or implantable treatments.
  • Prescription Submission: Fax to 833-830-1310 or Email to billing@elidah.com

Note that this is different from Medicare Advantage coverage (Part C). If you have Medicare Advantage, continue reading HERE.

  • You

    Share the Rx/Detailed Written Order (DWO) form (or this page) with your doctor.  This has all the information they need to write your prescription.

  • Doctor

    Your doctor completes the DWO and sends it to us. It’s important that they include notes referencing at least 4-weeks of attempted pelvic floor exercises.

  • Us

    We’ll review the DWO for completeness and submit it to Medicare.  We’ll be in contact with you along the way to arrange delivery of your Elitone and collect any co-pays.

  • You

    Upon receiving your device, begin treating per the recommended schedule and get ready to live Life Leak Free®. Follow up with your doctor as needed.

Download Rx Form/Detailed Written Order

Do You Have Another Type of Insurance?

If you have Medicare Advantage (“Part C”), Medicaid, or private insurance, your Elitone or Elitone URGE may be covered, but you’ll need to follow a different and longer process. Neither coverage nor processing is guaranteed, and many women opt to self-pay using their HSA/FSA funds.

Learn More

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