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@missjb
What is the cost if insurance doesn't cover this treatment?

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Replies to "@missjb What is the cost if insurance doesn't cover this treatment?"

@hirschho Hello:

I asked last April (when I first got my Nidra) what they cost--- out of curiosity--- and I was told $6,000 or $7,000. I can't remember which--but shocking!

Medical equipment!!!! What can I say! It is ALL overpriced!!! On the other hand, it was developed through medical research--which cost the company. This is not snake-oil. It is something that has been shown to work--a number of studies were published in the medical literature-- before it was ever available through prescription.

I learned about Nidra reading articles on pubmed and then I googled Noctrix for their phone number and cold-called the company--and I asked the exact same questions: can I buy one? what does it cost?

(They told me "no"---I'll explain why)

No one expects you to pay out-of-pocket. No more than anyone expects you to pay for a surgery or chemotherapy or other FDA approved medical intervention that is very expensive. That's why we have insurance.

The bands are well designed (except the velcro can be a bit touchy). They are comfortable. They work. That is the main thing: they work!

But, you want to have insurance pay for them (like we couldn't easily pay out-of-pocket for care in the ER or an in-patient hospital stay). Insurance is expected to be involved.

Noctrix has a list of doctors (by state) who prescribe the Nidra. I was told initially that sometimes there was a "hitch" if the ordering doctor didn't give the right historic information--and this could make insurance approval take longer. My doctor is a RLS expert (had ordered for other people previously) and between his ordering and my picking Nidra up was only 2 or 3 weeks. ("Only" a relative term when one isn't able to sleep very well).

My medicare and supplemental insurance paid 100% --which a Noctrix nurse told me (beforehand) I should expect.

The Noctrix company will tell you what to expect from your insurance before you ever have one ordered, if you call them.

I read a posting on a Mayo connect thread by someone whose Nidra was not paid for by Medicare 100%. My husband told me that Medicare plans can vary by state. All I know is that mine was.

Call Noctrix and talk to someone. (google their phone #. Look on their website. Noctrix.com)

Nidra requires a medical prescription (like medications that aren't OTC). You can't just buy one. It has to be ordered by a doctor. Then, Noctrix handles submitting the insurance claim. You just provide your insurance information along with the doctor's order.

Is it worth $7,000? Like all medical equipment, it is overpriced. Our whole medical system has major flaws. But, that is a whole other subject.

Is it worth calling and seeing what can be worked out with your insurance before you bother getting a doctor's order--absolutely!!!

I talked to the nicest, most caring nurse when I called. Not some sales rep. A nurse who understood my suffering and sincerely wanted to help. It wasn't available in my state, so I had to wait a year. Then, the Noctrix Company actually emailed me as a follow up and told me I could get one. That said a lot to me. A year later, out-of-the-blue, I get an email from Noctrix. They kept my email for a whole year and remembered my need. I felt like a patient and not a "customer."

That is one other caveat---The Noctrix Company needs support people in your state before you can get one. Most states are now covered, but not all. I had to wait a year because my state wasn't covered. New Mexico someone posted still isn't.

If you look on the Noctrix website you can see a map of which states aren't ready yet.

I only write about Nidra because it has helped me and I want others with RLS to have the same help...

RLS stole 15 years of my life and gave me insomnia and made me realize death was better than the life I was living.

Appropriate medication AND the Nidra-- in combination-- has given me 7 symptom free nights in the last 8. Plus, it relieved my RLS in a couple minutes the night I needed to turn it on. No wonder I rave about it !!!

I applaud you for expressing interest.

Best to you!