Sadly, as with most medical conditions, treatment will generally involve something whether it is medication or, in the case of Seasonal Affective Disorder, a light box and light therapy to encourage faster results. The problem with this is that there are some insurance companies that won’t pay out for a light box.
This is where you need to think about things logically.
Get a full diagnosis first
In order to get reimbursed for your light box, you’ll need to be able to show that you NEED it in order to function properly and maintain a ‘normal’ way of day-to-day life. This means that you will need to have undergone a full diagnosis with tests and examinations with a doctor in order to prove that you actually have the condition.
Before you treat yourself for any medical condition you THINK you have, you should make sure that you actually have it and the only way to do that is with a full, professional, medical diagnosis. This is not only for your safety, but also to make sure you are covered when you try to make any medical insurance claims. Once the doctor has shown that you DO have the condition, you can then take the active steps to go ahead and treat it. You can’t show that you actually NEED the light box to your insurance company if you’ve never officially been diagnosed.
Talk to your insurance company
Once you’ve been diagnosed with the problem and the doctor has suggested that a light box could be the solution, it’s probably worth having a chat with your insurance company to see what they offer in the form of coverage for such a device. You will need to do your homework carefully as you won’t want to spend out a small fortune for something and have no guarantee that you’ll get it paid back to you. By calling up in advance and finding out what your options are prior to buying, you won’t have any unhappy surprises later on that might just leave you out of pocket.
Some find that their insurance company will pay up to 50% of their light box costs. Others have found that they have been paid out for the full price of it. There are a few unlucky ones out there that have shown not to be covered at all and despite appeals, have never been reimbursed for it. Before you even begin to think about shopping around, give them a call and see what they suggest.
The other problem you are faced with when coming up close and personal with these insurance guys is that the light boxes themselves haven’t actually been FDA approved. Technically, the companies are well within their rights to confirm the treatment as “experimental” rather than an actual form of appropriate care for conditions like stress, anxiety, depression and seasonal affective disorder, and refuse to pay out at all for it.
Get a written statement from your insurance company
When you call up and enquire if they “will”, “may” or “won’t” pay out for this form of light therapy, make sure that you get them to email or send you out a copy of what they have just said, or read through the terms and conditions for your policy to see any small print that may avoid the claim from being successful. If you don’t have it in writing, don’t take it as the truth. You know… just in case. Plus some claims have been rejected because the light box had been purchased before the full diagnosis and prescription for the device was made. Technically, you weren’t diagnosed yet so you couldn’t have been sure you really needed the device.
You know what the insurance companies are like for their loopholes!
A letter from your doctor can help
Of course, if you are having a bit of a struggle with your insurance company and feel they might be pushing towards the direction of actually paying out, a well-timed official letter from your doctor will generally do the trick. You can find templates of these online with a bit of Googling. There is also a sample letter in Dr. Norman Rosenthal’s book, Winter Blues. You’ll be surprised at how much the right kind of wording will achieve.
Most people have found that they get the best results when trying to claim for their light box by sending an invoice for the light box itself along with this official letter from the doctor to confirm the device is indeed necessary for recovery. That’s the thing about stress, depression, SAD and anxiety – the conditions have the potential to completely destroy your life if you let it, and without the right treatment (for example, the light box and other forms of light therapy), regardless of how experimental it is, you can’t go about your day to day life. You can’t go to work and earn money or provide for your children and provide a roof over their heads. You can’t live life like you normally would. And that’s why you need the light box to get better, you see?
This form of light therapy has been used to treat conditions just like the ones mentioned since the early 80’s proving that there is some substance to the claims that they can help. They wouldn’t still be around now if there was no truth to them. In fact, about 80% of people find light boxes useful for helping with Seasonal Affective Disorder.
At the end of the day, always get in touch with your insurance company prior to making any buying decisions. If you are prepared and have all the information you need, buying the light box will be the best decision you’ve ever made. With the potential to completely change the way you live your life, it makes sense to take your time and make sure you have everything handy.
Thanks for this. Just trying to learn more after I discovered that my insurance will not cover the light therapy box. Trying to stay off medication and use alternate methods to treat! I wish they would consider that light boxes are therapeutic and have been shown by scientific studies to help in the condition of winter blues or SAD.
Who makes the decisions on what is covered and what is not? Light therapy is a one time cost that you can continue to use for years. This would be healthier than prescribed medications. Insurance companies never hesitate to cover doctor ordered prescriptions that may not help and have very serious side effects. It would be cheaper to use the light instead. Unreal that patients are denied this healthier choice.
Men in suits who don’t have to worry about healthcare.