Eagle Rock Neuropathy and Pain Logo

🔑 Quick Answer

Yes, most insurance plans including Medicare Part B cover peripheral nerve stimulation (PNS) therapy for chronic neuropathy in Idaho Falls. Medicare covers 80% of PNS costs after the annual deductible, with typical out-of-pocket costs of $500-$2,000. Commercial insurance plans (Blue Cross, United Healthcare, Regence) also cover PNS with varying copays and deductibles. At Eagle Rock Neuropathy and Pain Center, we handle all pre-authorization, medical necessity documentation, and insurance billing. Coverage requirements include: chronic pain 6+ months, failed conservative treatments, and successful trial stimulation. We verify coverage before treatment begins.

Does Insurance Cover Neuropathy Treatment in Idaho Falls?

Insurance Coverage by Plan Type

Medicare Part B

Coverage Details:

  • • Covers 80% after deductible
  • • 2025 deductible: $240
  • • No prior auth usually required
  • • Covers device replacement

Your Cost:

  • • Typical: $500-$2,000
  • • With Medigap: $0-$500
  • • Includes all procedure costs
  • • Follow-up covered 100%

Medicare Advantage (Part C)

Coverage Details:

  • • Must be in-network provider
  • • Prior authorization required
  • • Plan-specific coverage
  • • Max out-of-pocket applies

Your Cost:

  • • Copay: $500-$1,500
  • • Verify with specific plan
  • • Eagle Rock is in-network with most MA plans

Commercial Insurance

Major Plans We Accept:

  • • Blue Cross Blue Shield of Idaho
  • • United Healthcare
  • • Regence BlueShield
  • • Aetna
  • • Cigna

Typical Coverage:

  • • 70-90% after deductible
  • • Prior authorization required
  • • In-network rates apply
  • • Verify specific benefits

What Insurance Requires for Coverage

Standard Medical Necessity Criteria:

  1. Chronic pain diagnosis - Documented 6+ months of neuropathic pain
  2. Failed conservative treatment - Tried at least 2 medications or therapies
  3. Functional impairment - Pain significantly affects daily activities
  4. Trial stimulation success - 50%+ pain relief during trial period
  5. Psychological clearance - Standard evaluation for implantable devices

Eagle Rock handles all documentation and pre-authorization - you don't manage insurance requirements alone.

Free Insurance Verification Process

1

Submit Insurance Information

Provide insurance card details during scheduling or at first appointment

2

We Verify Coverage

Eagle Rock contacts your insurance to confirm PNS coverage and benefits

3

Receive Cost Estimate

Get exact out-of-pocket costs before proceeding with treatment

4

Pre-Authorization Handled

We submit all required documentation and obtain insurance approval

What If Insurance Denies Coverage?

Eagle Rock has a 95%+ approval rate, but if denied:

Free Insurance Verification in Idaho Falls

Find out your exact coverage and out-of-pocket costs before your consultation. We verify benefits for all major insurance plans within 24 hours.

Check Your Insurance Coverage

Call: (208) 537-1090