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, reimbursement may take several months and is not guaranteed. Purchases through insurance do not qualify for Elitone’s online pricing, free shipping, return policy, or promotions. This page provides details to help navigate your options.

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.

Medicare Process Steps

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.

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.

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)