Insurance Coverage / Reimbursement

Good news: Elitone may be covered by insurance. We process Original Medicare claims directly to make things easier for you. For Medicare Advantage or private insurance, billing is handled by a third party and coverage is not guaranteed. Insurance purchases do not qualify for online pricing, free shipping, returns, or promotions. This page helps you understand your options.

Elitone and Elitone URGE are Medicare Part B (Original Medicare) eligible. View the step-by-step Medicare Guide here.

Quick Overview
• Your doctor sends us a prescription (DWO) with brief clinical notes.
• We text you when processing starts and contact you to confirm any co-pay and collect required forms.
• You sign required documents and we ship Elitone to your home.

Tip:
Most delays happen when we are waiting on missing information or signatures, or when we are unable to reach the patient or doctor.
Please watch for calls, texts, and emails (check your spam) from Elidah or Elitone and respond promptly to avoid delays.

NOTICE: We can process Medicaid in Arkansas, Connecticut, Idaho, Indiana, Minnesota, New Jersey, Oklahoma, Texas, Washington.

We cannot process Medicare Advantage, or private insurance at this time.

Elitone and Elitone URGE are covered by SOME providers, but coverage depends on your specific plan. We can provide an initial eligibility assessment, but processing/billing must be handled by an in-network partner. In many cases this takes 4-8 weeks and is ultimately denied. Because of this, most women opt to self-pay to begin treatment right away. If you choose to pursue coverage, here are the next steps:

  1. Your healthcare provider sends us a prescription.
  2. You will receive a TEXT from us, letting you know that we’re started the assessment.
  3. You will receive a CALL or EMAIL detailing your eligibility.
  4. If you are NOT ELIGIBLE for coverage you will be given an opportunity to self-pay and have the expense count toward any insurance deductible.
  5. If you are ELIGIBLE for coverage and there is an in-network billing partner, your prescription will be forwarded for processing. That partner will contact you with further instructions.
  6. You review and sign documents and complete payment as applicable.
  7. Elitone is shipped to your home.

This process typically takes 4-8 weeks (or longer) depending on how quickly you and your insurer respond to request for additional information, and the availability of an in-network billing partner.

Notes:

  • Coverage is not guaranteed.
  • The timeline for this process can vary significantly

Elitone and Elitone URGE are available without a prescription, so many patients opt to self-pay and avoid delays due to insurance processing. Your next steps for self-pay include:

  1. Select Elitone or Elitone URGE. If you’re not sure which one, complete the “Which Elitone is Right for Me?” quiz.
  2. Add to cart and select from multiple payment options, including Affirm for monthly-payments, or  HSA/FSA account.
  3. Product typically ships the next day.

Notes:

  • This purchase method is eligible for our 60-day money back guarantee

Please note, it can take 3 weeks to process an original Medicare form and much longer for other plans.

Expect a call or email from 203-508-4249 (Serrena). You may also contact that number or email billing@elidah.com at any time.

The slowest part is trying to reach you for more information. You can be proactive by providing your insurance information (if you haven’t) and signing the forms:

Manufacturer: Elidah, 31 Pecks Ln Ste 11, Newtown CT 06470

Elidah has obtained these insurance codes for the Elitone product lines.

Product Name HCPCS/DME Code Description
Elitone E0740-NU Non-implanted pelvic floor electrical stimulator, complete.
Elitone URGE E0740-NU Non-implanted pelvic floor electrical stimulator, complete.
Elitone GelPads Pack of 5 A4595 Electrical stimulator supplies

Additional reference diagnostic codes:

  • ICD-10-CM Code – N39.3     Stress urinary incontinence (SUI)
  • ICD-10-CM Code – N39.46  Mixed urinary incontinence (MUI)
  • ICD-10-CM Code – N39.41   Urge urinary incontinence (UUI)

Medicare

Elitone is approved for nationwide Medicare Part B coverage 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 for Elitone or Elitone URGE, including a Medical Necessity Statement. See Detailed Written Order (DWO).
  • Physician documentation proving a 4-week trial of pelvic floor muscle exercises attempted with additional intervention needed.
  • (Preferred) Chart notes supporting the need for neuromuscular electrical stimulation before considering surgical or implantable treatments.
  • Prescription Submission: Fax: 833-830-1310 | Email: billing@elidah.com

Note: Medicare Advantage (Part C) follows the same requirements but often requires an in-network, state-specific DME provider. Coverage, co-pays, and availability vary, and we may not have a DME provider for the specific plan.

Private Insurance

Many private insurers provide coverage for devices like Elitone. Every insurer has different coverage policies and requirements. Ask your insurance provider first if they cover Elitone (use the codes and information below) and whether there are pre-requirements (see examples under the Medicare section).

  • If you meet the requirements, your insurer may provide reimbursement after completing your purchase from elitone.com, or we can attempt to bill first. Contact billing@elidah.com.  Do not call customer service as that is a different department.
  • NOTE: We know that Blue Cross Blue Shields (BCBS) insurance does NOT cover Elitone unfortunately.

Did you know that Elitone can be paid for under FSA or HSA? This often is a great option if you have a high deductible that is not met. Just checkout on our website and pay with SIKA.

Medicaid

Medicaid is state-specific and the requirements vary. Although the list is growing, Medicaid can cover Elitone in the following states: Arkansas, Connecticut, Idaho, Indiana, Minnesota, Oklahoma, Texas, & Washington.