Insurance Coverage / Reimbursement

Elitone is covered under some insurance plans! Elidah (that’s us) processes Original Medicare claims, making it easier for you to get coverage. For Medicare Advantage or private insurance, processing and billing must be handles by a third party, often takes several months, and coverage is not guaranteed. Purchases utilizing insurance do not qualify for Elitone’s online pricing, free shipping, return policy, or promotions. This page provides details to help navigate your options.

Detailed Written Order (Rx Form)
Reimbursement Guide
Elitone Info for Doctor & DWO

Elitone and Elitone URGE are Medicare Part B (Original Medicare) eligible. Here are the next steps:

  1. Your healthcare provider sends us a prescription using this form.
  2. You will receive a TEXT from us, letting you know that we’ve started to process your prescription.
  3. You will receive a CALL or EMAIL detailing any co-pay and confirming that you want to proceed.
  4. You complete/sign provided documents, including payment information as applicable.
  5. We ship Elitone to your home to begin treatment.

This process typically takes 1-3 weeks, depending on how quickly you respond to calls and emails.

Notes:

  • This process is NOT applicable to Medicare Advantage.
  • Coverage is not guaranteed.
  • The product is billed over 13 monthly payments.
  • Co-pays can be billed monthly or as a lump sum.

NOTICE: We cannot process Medicare Advantage, Medicaid, 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. Visit the Products section of this website and 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 begin checkout.
  3. Select from multiple payment options, including Affirm for monthly-payments, or SIKA to use an HSA/FSA account.
  4. Product typically ships next day.

Notes:

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

Product and Manufacturer Information

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

Product Support (not billing):  customercare@elitone.com | 978-435-4324 | elitone.com/contact-us

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, Idaho, Minnesota, Oklahoma, Texas, Washington.