February 9, 2023

Q: How can I get a prescription for a cooling vest?

A: Talk to your doctor. Explain your heat sensitivity issues and concerns and the benefits you would receive from having a cooling vest. Our ThermApparel UnderCool Cooling vest's health benefits are;

Reduce Flare-ups - By keeping your core temp stable will prevent the escalation of existing symptoms or the appearance of new ones.
Less fatigue - You won't be as tired and wiped out from the heat allowing you to engage more and get more things done.
Less cog-fog - You will have better concentration and fewer moments of forgetfulness or that "stuck" feeling.
Exercise - You won't overheat allowing you to exercise and reap the health benefits.
Social Engagement - You will be able to go to outdoor events with family and friends, like picnics, celebrations, kids' soccer games, etc.

Q: Do I need a prescription for a cooling vest?

A: Possibly...it depends if your insurance will cover cooling vests.

Q: My claim was denied, what do I do now?

File an appeal to reverse the denial.
Contact your insurance company and find out if you can use your FSA or HSA funds.
Apply to a Cooling Program.
Contact us for a Letter of Network Deficiency.

Q: Does ThermApparel accept insurance?

A: No, we don't. The reason for that is that 99% of insurance providers deny coverage for cooling vests. They don't think they are medically necessary...we know, we think it's silly too. That's not to say it isn't possible, it all depends on your insurance provider and your individual plan.

Please note: ThermApparel is a small company and we cannot bill any insurance provider directly. But we can help the process by providing invoices and or medical receipts / and information on our product.

Q: I have a prescription for a cooling vest will my insurance will pay for it?

A: Congrats on getting a prescription for a cooling vest! That is awesome. You can purchase an UnderCool Cooling Vest through us once the approval process from your insurance company is completed. Don't purchase until you have the approval of your insurance company otherwise, they will not pay for it.

Please note, ThermApparel is not responsible for your prescription, claim, or denial and we can not guarantee that these steps will work as each insurance provider, situation and patient are different.

Be patient with the approval process as most insurance providers require weeks to months to come to a decision. In most cases, insurance providers will deny your first claim. In this case, you will need to file an appeal to reverse the denial. Appeals require another few weeks for insurance providers to review.

We have had customers use their HSA (Health Savings Account) or FSA (Flexible Spending Account) to purchase a ThermApparel Cooling Vest. Please contact your insurance provider before you purchase to make sure they will accept this use of your HSA or FSA funds. Then make your purchase in our shop.

Here are a few tips to ensure the approval process goes as smoothly as it can:

Talk to your doctor. It's important to talk to your doctor or healthcare provider to receive their support as many insurance providers require a written prescription and letter of medical necessity from your doctor.
Gather all of your relevant medical records and history. Insurance providers may want you to mail or fax these records with the claim.
Contact your insurance provider. Let them know you want to purchase a ThermApparel Cooling Vest. ThermApparel is a registered DME vendor. The healthcare code to classify a ThermApparel Cooling Vest is E1399 - Misc. DME (Durable Medical Equipment). Because of this code, some insurance providers may only need a letter of medical necessity written by your doctor and an invoice or medical receipt from us.
If they cover it, awesome! Ask how reimbursement works. ThermApparel is unable to submit the paperwork for you so you will have to get approval from the insurance provider first, then purchase a ThermApparel Cooling Vest according to their reimbursement rules and policy. Insurance providers will not reimburse you for a ThermApparel Cooling Vest if you purchase before their approval.
If they deny it and say a ThermApparel Cooling Vest is not covered as durable medical equipment, they won't cover it. That's ok! There are a few other things you can do, but they take a bit of work on your part.
Ask your insurance provider what is the financial threshold for needing prior authorization for your plan. Let your insurance provider know that a ThermApparel Cooling Vest costs less than $500 as this is a general threshold for needing prior authorization. Because of this, some providers will automatically approve your ThermApparel Cooling Vest purchase. Please remember to wait for approval before purchasing a ThermApparel Cooling Vest and ask your insurance provider what their reimbursement steps are.
If step 6 doesn’t work, we can supply you with a Letter of Network Deficiency and an invoice or medical receipt. Send us an e-mail at contact.us@thermapparel.com and fill us in on where you are in the process and we can get the letters out to you. We will need your full name (as it appears on your insurance card), mailing address, and date of birth. If you are not comfortable giving us that info in an email give us a call at 855-232-7233.
Get a Letter of Medical Necessity from your doctor. You can download a template for your doctor to alter for your specific needs.
Submit all three letters, prescriptions, and invoices or medical receipts to your insurance provider and wait. Be persistent, nice, and follow up consistently. Be prepared that they will most likely decline your claim.
If they accept it, awesome! Clarify with your insurance provider how reimbursement works before you purchase a ThermApparel Cooling Vest and then purchase in our shop or call us at 855-232-7233 we are happy to help place your ThermApparel Cooling Vest order and issue a medical receipt for reimbursement.
If they deny your claim, there are still things you can do. Try to file an appeal or apply to a cooling program.

Tips from ThermApparel Customer Alice

Be sure to include all information requested.
Keep copies of everything submitted and the dates submitted.
If asked for additional information, document who asked for it and whether they want all previous paperwork summited along with the new information.
Document all phone calls. This includes who you spoke to, dates, and times.
Don't give up. It may take 8 to 9 months.

Tips for Filing an Appeal Letter for A Cooling Vest for Patients

Talk to your health insurance company to find out their process for filing an appeal letter and what paperwork you will need.
Submit the Cooling Vest Appeal Letter and the 2 studies via email, snail mail, carrier pigeon, etc, or, our recommendation, the approved method from your insurance company.
Wait to hear back from the insurance company but be persistent and nice and follow up consistently.

The 2 studies that are mentioned in the model appeal letter are:

Clinical and Immunological Effects of Cooling in Multiple Sclerosis by P.K. Coyle, L.B. Krupp, C. Doscher

A randomized controlled study of the acute and chronic effects of cooling therapy for MS. by SR Schwid, MD Petrie, R Murry

Tips for Applying to an MS Cooling Program for Financial Assistance with a Cooling Vest.

There are many foundations and organizations out there that offer financial assistance for various things. Check out their websites to see if they offer Cooling Programs.
Call or email if you have any questions. For example, the National MS Society's Navigators are amazing and will be able to help you through the process.
Choose ThermApparel as your cooling choice. Give us a call (855-232-7233) if you need help with sizing.
Submit your application.
Once approved we will ship it to you.

Here are our suggestions for MS-related Financial Assistance for Cooling Vests.

National MS Society - 1-800-344-4867 - The Cooling Program is open year-round and they have authorization to our full inventory. The Navigators can help you with their Cooling Program and the appeal process. When you call, ask to speak to an MS Navigator. Tell them you need financial assistance for a ThermApparel Cooling Vest. They will take it from there. If you need help with sizing, please give us a call at 855-232-7233.
MS Navigators
MS Navigator brochure

MS Foundation - 888-673-6287 - The Cooling Program is open Feb 1 - June 1 and they have authorization for SlimCool only. The MS Foundation Cooling Plan application is online and in print form.
Cooling Program
Grants and Programs

Q: I don't have MS are there other foundations that might be able to help me?

A: Possibly. We have created a list of foundations and organizations that offer financial assistance for various things. It is recommended that you review any information you get from searching on the Internet with your healthcare professional who is your primary resource to meet your individual medical needs.

Please note that ThermApparel can not guarantee the accuracy or your ability to qualify for any of the programs. ThermApparel does not monitor, substantiate, or endorse the information offered on these sites.

Tired of scrolling to find the link you need? No worries, here's a full list of all the links from this blog.

heat sensitivity

What is heat sensitivity and how does heat affect my body? Learn this and the different strategies for cooling, and the many strategies available to reduce the risk of heat so you can improve your #HeatIQ and make a plan to keep doing the things you love in our 7-part blog Crafting a Personalized Cooling Plan.

file an appeal

Tips on how to file an appeal letter to your insurance company.

letter of medical necessity

Download a template for your doctor to alter for your specific needs.

It's ok if you are not a clinician or you don't have MS, you can still use the template in the Health Insurance Appeal Letter Toolkit for Clinicians for the Cooling Vest Appeal Letter. You have to scroll down quite a bit to get to the Cooling Vest Model Appeal Letter and Abstracts of Studies cited in appeal letters.

Clinical and Immunological Effects of Cooling in Multiple Sclerosis P.K. Coyle, L.B. Krupp, C. Doscher

The study is cited in the model appeal letter.

A randomized controlled study of the acute and chronic effects of cooling therapy for MS. SR Schwid, MD Petrie, R Murry