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Hi there,
I just discovered this thread. My doctor submitted the prescription for the Nidra and the company has called me to set it up. However, even with 3 phone calls to Medicare, I can't get any verification that it will be covered. I've had RlS for years and I'm on pregabalin and ropinirole. My doc doesn't want to increase the ropinirole any higher. When I gave the medicare persons the codes and the provider number, they couldn't find anything. Do I just say yes to the Nidra consultant and hope for the best? I don't want a huge bill if it's not covered. Why can't I get a pre-approval?
thank you!
Replies to "Hi there, I just discovered this thread. My doctor submitted the prescription for the Nidra and..."
@lk8 Why don't you call the Noctrix Company (it's in California--it's address and phone number can be googled)? They make the Nidra, so "sales" are in the best interest in the company. From my limited knowledge, it seems a number of insurance claims have been denied. Noctrix will have the best handle on how to deal with insurance and they (for me) have been incredibly nice and helpful when I communicated with them. (You probably read that I'm one of Nidra's success stories from my postings--I hope you get the device and I hope it is equally effective for you).
@lk8 After my last post, I put my husband to work--looking for the answer to why Nidra is denied by Medicare. He found (on some FDA or Medicare website) that approvals are based on medication being trying and not working adequately. My medication helped prior to Nidra, but my symptoms continued and were still significant. It sounds like that kind of a scenario needs to be expressed when Nidra is prescribed. I hope this is helpful information.
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@lk8
Hey there! I would not accept anything until you are sure you are approved. Call your doctor back. His nurse will get you preapproval of either let you know you are not approved. Hopefully, you will get approved and have great success! I am so pleased. Only been on since April 2026. Good luck!
kdunn44