In the Pink is proud to be an approved Medicare, Tricare (Standard, Prime and Tricare for Life), Blue Cross Blue Shield, Multi-Plan, Veteran's Administration, Cigna, Devoted Health, Care Plus and United Healthcare provider. We will file the claims for you. If you have insurance coverage, be sure to bring your insurance card and prescriptions for the items you need. Unfortunately, Medicare does not cover Wigs/Cranial Prosthesis or custom prosthesis. However, the Lymphedema Treatment Act took effect on January 1, 2024 so they DO cover compression garments!
Many insurance companies do not have an APPROVED provider in Jacksonville for mastectomy or compression products. When that is true, you may be able to get the items you need by negotiating with your insurance carrier for a "gap exception" or "network inadequacy" letter of authorization. In order to do this, follow the instructions below.
If Aetna is your insurance, we now only accept plans that have ESA written on your card. If yours is not an ESA program, follow these instructions:
- Call the Member Services number on the back of your card.
- Tell them you are requesting services from In the Pink because there is a “NETWORK INADEQUACY” in services for Aetna patients in the Jacksonville area. NO ONE in Jacksonville serves Aetna patients for the items you need. Ask that they AUTHORIZE services for In the Pink to provide your items.
- These items might include:
- Mastectomy Bra (HCPCS code L8000)…they usually allow 4 bras per year.
- Mastectomy Prosthesis (HCPCS code L8030)…should allow one per missing breast or partial breast
- Post-Surgical Garment (HCPCS code L8015)…should allow two per surgery (one to wash, one to wear)
- Wig/Cranial Prosthesis (HCPCS code A9282)…should allow just one. Ask them for the $$ limit.
- Lymphedema Compression Sleeve (HCPCS code A6578)…they should allow two (wash one/wear one)
- Lymphedema Compression Glove (HCPCS code A6581)…they should allow two (wash one/wear one)
- There may be additional items that you may need. We can discuss this on an individual basis.
- They will send you an authorization, as well as one to In the Pink.
- Here is other information they may ask for:
In the Pink Boutique Inc. (our formal name)
522 Third Street North
Jacksonville Beach, FL 32250
Phone: 904-372-0029
Fax: 904-372-0063
- NPI# 1134356835
- Tax ID# 26-4471182
If you are covered by Blue Cross Blue Shield, please be aware that CareCentrix will partner with Blue Cross Blue Shield Florida to manage claims for all durable medical equipment, such as those provided at In the Pink. YOU WILL STILL BE COVERED FOR THE ITEMS NEEDED!
YOU MUST HAVE AN APPOINTMENT FOR MASTECTOMY PRODUCTS, WIG and/or LYMPHEDEMA FITTINGS. This requires less wait time for each client and allows us to spend the time needed for an appropriate fitting. It also allows us to clean between fittings. Please call 904-372-0029.
Prescriptions you might need would include: post-mastectomy surgical camisole, mastectomy bra, mastectomy prosthesis, and/or compression garments for treatment of lymphedema. Ask your doctor to write your diagnosis on the prescription, as well as his NPI number.
If it is easier for you to have your prescriptions faxed, please fax them to 904-372-0063.
In order for compression garments to be covered by insurance, the only codes that are accepted by insurance include:
- I97.2: Post-mastectomy lymphedema syndrome
- I89.0: Lymphedema, Not elsewhere classified
- Q82.0: Hereditary lymphedema
- I97.89: Other post-procedural complications and disorders of the circulatory system, not elsewhere classified