![]() It applies to employer-based plans, as well as those that people buy on the individual market. The law requires insurers that provide coverage for mastectomies to also cover complications related to the procedure, including these socks and sleeves. The 1998 federal Women’s Health and Cancer Rights Act has helped some patients get insurers to cover their compression garments. Garments should be replaced two to four times a year, Rockson said. Some patients need custom garments because the standard size cannot adequately accommodate the affected area. When made to order, the price can jump to $960. One pair of waist-high stockings costs $159 off the shelf. A standard-fit arm sleeve costs $81, but a custom-made equivalent can run $202, according to the Lymphedema Advocacy Group, a patient volunteer organization seeking a federal mandate for insurance coverage. Depending on the severity of the disease, some people also require them at night. Stanley Rockson, a professor of lymphatic research and medicine at Stanford University School of Medicine in California. People generally wear the garments daily, said Dr. The majority develop the condition after undergoing cancer treatment, especially if they had surgery that required removing lymph nodes to stop the spread of disease. Breast cancer patients are particularly affected by the condition. Lymphedema affects as many as 5 million people in the United States. “Right now there is a patch quilt across the country to navigate to get the care that you need,” said William Repicci, CEO of the Lymphatic Education & Research Network, a patient advocacy group. Although Medicaid programs cover some of these expenses, Medicare does not.Īdvocates have been pushing for legislation to change that. Coverage varies among private insurance plans, and for many patients it is limited. Many lymphedema patients struggle to get health insurers to pay for compression garments. That’s a condition that occurs when fluid builds up in the arms and legs. “I guess they’re thinking I don’t have to stand up” for half the year, she said.īritta Vander Linden uses compression stockings to help prevent complications from her lymphedema. For the rest of the year, she added, she pays out of pocket ― between $2,500 and $3,500 annually. Vander Linden’s insurance coverage, which she gets through her job as a senior director of communications at a Washington, D.C.-based nonprofit organization, covers about half the annual cost of her stockings, she said. Lymphedema is incurable, but specialized compression stockings, sleeves and gloves help prevent complications such as tissue damage, more swelling and infection. When that network is damaged, fluid can build up and cause limbs to swell well beyond their normal size and make them susceptible to harmful infections. The condition affects the lymphatic system, a network of lymph nodes and vessels that move infection-fighting liquid through the body. That’s because Vander Linden, 44, was born with lymphedema. She relies on the garments to stand and walk without intense leg pain and swelling. This story can be republished for free ( details).Įvery morning, Britta Vander Linden dons compression stockings, a cumbersome process she calls “putting on my legs.” This story also ran on The Washington Post.
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