Does Lice Clinics of America Take Insurance?

Does Insurance Cover Lice Treatment_
Does Insurance Cover Lice Treatment_

Discovering head lice on your child is every parent’s nightmare. The itching and discomfort of a lice infestation can be extremely disruptive for families. On top of that, treatment and prevention add unexpected costs. That’s why many parents wonder: does Lice Clinics of America take insurance?

The good news is that many Lice Clinics of America locations do accept insurance for lice treatment services. With the right insurance coverage, you may be able to get lice removal treatment covered partially or in full.

In this blog post, we’ll cover everything you need to know about using insurance for lice treatment at Lice Clinics of America. Read on to find out if your health insurance plan will help pay for lice removal services.

How Much Does Lice Treatment Cost at Lice Clinics of America?

Lice Clinics of America offers professional, guaranteed lice treatment at nationwide clinics. Their flagship service is AirAllé—an FDA-cleared, single-treatment lice removal method that kills lice and eggs in one appointment.

The cost for AirAllé treatment ranges from $150 to $350 per person depending on the clinic location. Most clinics offer a 15% discount for additional family members receiving treatment simultaneously.

Read more: Crime Insurance Application: Simplified Process for Comprehensive Coverage

Some Lice Clinics of America locations also offer traditional lice combing and picking services for a lower price point. These labour-intensive methods require repeat visits over 2 weeks to remove lice after treatment manually.

For severe infestations, Lice Clinics of America offers an intensive Triple Play treatment package that combines AirAllé with combing, and an additional AirAllé appointment 14 days later.

As you can see, total costs for complete lice removal and prevention can add up quickly for families—especially those with multiple children affected. That’s where insurance billing may help alleviate the financial strain.

Does Insurance Cover Lice Treatment at Lice Clinics of America?

Many Lice Clinics of America locations accept insurance plans and will submit claims on your behalf. However, coverage for lice treatment can vary greatly depending on the specifics of your health insurance policy.

Here are some key factors that determine whether your health insurance will cover lice removal services:

  • Insurance Provider: Each company sets its own policies about what healthcare services are covered. Lice treatment coverage is more common with PPO plans. HMO plans often require a referral from your primary care physician.
  • Covered Dependents: Insurance billing may only apply for covered members on the policy, such as primary policyholders and dependent children. Other family members may need to pay out-of-pocket.
  • In-Network Status: Seeing an in-network provider gives you the best chance for coverage. Verify that your local Lice Clinics of America is in-network with your insurer.
  • Type of Treatment: Insurance is more likely to cover AirAllé medical device treatment than manual nitpicking. Procedures deemed medically necessary have better coverage odds.
  • Benefit Limits: Even if lice treatment is covered, your plan may cap the dollar amount per year or the number of procedures allowed. You may owe the remainder.

Bottom line: contact your insurer and local lice clinic to learn about your specific medical policy and what portion may be covered. Don’t assume treatment will be 100% paid for by insurance.

Real-Life Story: How One Family Got Lice Treatment Covered

Let’s walk through a real-life example to understand how insurance billing works for lice removal.

The Wilson family had a lice outbreak among their three school-aged children. They brought all three kids into their local Lice Clinics of America for AirAllé treatment.

The clinic confirmed that Wilson’s Blue Cross Blue Shield PPO insurance plan covers lice treatment. So the Wilson parents only had to pay a $35 copay per child.

Two weeks later, some lingering live lice remained on their oldest daughter’s head. So she went back for a follow-up AirAllé treatment. Thankfully, their insurance covered this second appointment as well with just another $35 copay.

The Wilson family paid $140 out of pocket for lice removal treatment that would have cost over $1000 without insurance. While lice infestations are no fun, using their health insurance relieved their family during this stressful situation.

5 Things to Ask When Checking If Your Insurance Covers Lice Treatment

If lice have infested your family, don’t immediately panic about the treatment costs. There’s a good chance your health insurance may foot part of the bill.

To find out if your plan covers lice removal services, ask these key questions:

1. Is my Lice Clinics of America location in-network with my insurance provider?

This is the first step to getting coverage—the clinic must be in your insurer’s network. Have the clinic verify this when you call to make your appointment.

2. Do I need a referral from my doctor for insurance to cover lice treatment?

Some HMO plans require a referral from your primary care physician before covering specialist services like lice removal. Ask your insurer if this applies to you.

3. What CPT codes does the lice clinic use for billing?

Knowing the medical billing codes for lice treatment helps you check coverage details. Common codes are 99188 and 96522.

4. How much of the cost does my insurance cover for lice removal?

Don’t assume 100% coverage. Find out the dollar amount or percentage your plan covers. This determines your out-of-pocket cost.

5. Is there an annual limit on how much my insurer pays for lice treatment?

Plans often cap the total amount covered for a given service per year. Be aware of any maximum benefit limitations.

Getting answers to these questions upfront prevents insurance billing surprises down the road. You’ll know what to expect cost-wise before starting lice treatment.

Can I Get Reimbursed by Insurance for DIY Lice Treatment?

If you choose to treat lice at home using over-the-counter shampoos and combs, don’t expect insurance reimbursement. Insurance only covers professional medical treatment administered at the clinic.

You won’t be able to submit claims for prescription topical creams or medicated shampoos you buy at the pharmacy, either. Those medication costs would only be covered if prescribed by an in-network doctor and purchased at an in-network pharmacy.

The only sure way to take advantage of your lice treatment insurance benefits is to schedule professional AirAllé or manual removal services at a clinic like Lice Clinics of America. DIY approaches are unlikely to be reimbursable.

Top 5 Tips to Get the Most from Your Lice Treatment Insurance Benefits

Navigating health insurance can be complicated. Use these tips to ensure you maximise coverage for lice removal costs:

  • Verify in-network status— Double check the lice clinic is in your insurer’s coverage network.
  • Get a referral—Ask your doctor for a referral if your insurance requires it.
  • Call your insurer—Confirm coverage details for lice treatment.
  • Review your policy—Check for exclusions, limitations, and reimbursement procedures.
  • Save receipts—Keep detailed receipts to submit claims for reimbursement.

With the right insurance plan, you can substantially reduce the costs of professional lice treatment for your family. Follow the steps above to ease the financial stress and get your kids lice-free as quickly as possible.

Lice Treatment: Frequently Asked Insurance Questions

Below we’ve answered some common questions about using health insurance to cover the costs of lice removal services.

Does insurance cover lice removal combs and supplies?

At-home lice treatment kits are not covered by insurance. Only in-clinic professional services are potentially reimbursable if deemed medically necessary.

Will my HSA or FSA dollars cover lice treatment?

Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs) can be used to pay for lice removal costs not covered by your health insurance.

Do Medicaid plans cover lice treatment?

Coverage depends on your state’s Medicaid program. Several states do cover lice treatment and removal. Check with your Medicaid provider.

How long does it take for the lice clinic to get paid by insurance?

Payout timeframes vary. Many clinics offer payment plans so you can start treatment before insurance payments are finalised.

Do I need a doctor’s note for insurance to cover lice removal?

Your insurer may require a physician’s referral or notes documenting medical necessity. Check plan policies.

Will my insurance cover lice treatment for non-family members?

Most plans only cover policyholders and their enrolled dependents. Guests may need to pay out-of-pocket.

As you can see, insurance billing options can significantly reduce the headache and expense of a lice infestation. Consult the experts at Lice Clinics of America to find out if your health plan offers coverage for professional lice removal. Why pay more than you have to get those pesky parasites banished from your household for good?

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