Compression therapy questions, answered

It starts with your doctor. You need a prescription from a physician, nurse practitioner or physician assistant, and for most insurance plans you also need a recent progress note documenting your diagnosis.

From there we take over. Send us the paperwork by fax, email or bring it in, and we verify your insurance benefit in writing, tell you what you would owe before anything is ordered, and book your fitting. If you are not sure what to ask your provider for, call us first and we will tell you exactly what your plan will want to see.

The forms are all here, including the prescription forms to hand your provider.

For medical-grade compression — the kind insurance pays for, generally 20–30 mmHg and above, and anything custom — yes. A prescription is required, and it is also what makes the coverage possible.

Lighter over-the-counter compression, the sort worn for travel or long days on your feet, does not need one. You can buy those directly from our shop.

No. Lymphedema is the most common reason, but we fit patients for lipedema, chronic venous insufficiency, venous stasis and venous leg ulcers, post-surgical swelling, and general chronic leg swelling.

Coverage rules do vary by diagnosis, and some plans are stricter than others. That is exactly what we check for you before anything is ordered.

Call us. That is genuinely the fastest route, and it costs nothing.

Most people arrive not knowing whether they need a pump or garments, whether they qualify, or what their plan covers. We will walk through it on the phone, tell you which prescription form to take to your provider, and check your benefit for you once the paperwork is in.

800-883-1549, or text (517) 657-5223.

A lymphedema pump — properly a pneumatic compression device — is a small machine connected to an inflatable sleeve you wear on the affected limb. The sleeve is divided into chambers, and the pump inflates them in sequence from the far end of the limb toward the body, encouraging lymph fluid to move out of the swollen area.

You use it at home, sitting or lying down, usually for a set period each day that your therapist or physician specifies. Garments come in 4, 8 and 16 chamber configurations for legs, arms, the trunk and the chest.

Often, yes — but under different rules than garments, and this catches people out.

Compression pumps are not covered under the Lymphedema Treatment Act garment benefit. They are approved under separate pneumatic compression device criteria, with their own documentation requirements and, in most cases, prior authorization. Plans typically want a documented diagnosis, evidence that conservative treatment has been tried, and current measurements.

We check every requirement against your specific plan before anything is ordered, and we tell you in writing what you would owe. Checking is free and carries no obligation.

Yes. We lend pumps for home trials, and there is no charge for a trial and no obligation to order afterwards.

You get the pump and the garment set up in your home, with instruction on how to use it, and you try it for a period before any decision is made. This is the part most people are surprised we do — it means you find out whether it actually helps you before anyone bills anything.

The two forms that come with a trial are on the New Patient Forms page.

The conditions we most often see approved are:

• Lymphedema — primary or secondary, including after cancer treatment
• Chronic venous insufficiency, particularly with venous stasis ulcers that are not healing
• Lipedema
• Post-surgical and post-traumatic swelling

Qualifying is not automatic for any of them. Each plan applies its own criteria, which is why the documentation from your provider matters so much. Call us and we will tell you what yours is likely to want.

That depends entirely on your plan, your deductible and where you are in your plan year — which is why we will not quote you a number before we have checked.

What we will do is verify your benefit in writing and tell you your actual out-of-pocket cost before anything is ordered. No surprises, no bill you did not agree to. If your plan will not cover it, contact us and we can determine whether you are eligible to buy direct.

HSA and FSA cards and all major credit cards are accepted.

You will hear from us within two business days of your paperwork arriving. After that, the timeline is mostly set by your insurance, not by us — prior authorization is usually the long pole, and it varies widely by plan.

Two things hold orders up more than anything else: a prescription missing a required detail, and a progress note that is out of date. If you want to move quickly, get those two right and the rest tends to follow.

We supply Bio Compression Systems sequential circulators, along with the full range of pump garments — leg sleeves, arm sleeves, bio pants, abdominal garments and chest and vest garments, in 4, 8 and 16 chamber configurations.

Sizing charts and the garment instructions for use are in our Forms Center.

Let us be straightforward about this: we supply Bio Compression Systems pumps and we do not carry Tactile Medical Flexitouch, Lympha Press or BioTAB. Those are other manufacturers' products, and they are perfectly legitimate devices. So take the following as our view, not as neutral ground.

All sequential pneumatic compression devices work on the same principle — chambers inflating in sequence to move lymph fluid. Where they differ is in chamber count and layout, how the garments are constructed, the programmes available, and how the company sells to you.

The differences that tend to matter most in practice are not really about the machine:

• Who fits your garment. A pump is only as good as the garment fit. Ours are measured and fitted in person by a Certified Compression Therapist.
• Whether you can try it first. We lend pumps for home trials at no charge and with no obligation. Not every supplier does.
• Who handles the insurance. We verify your benefit in writing and tell you your cost before anything is ordered, and we handle the prior authorization and any appeal.
• Whether one company covers everything. We supply the pump and the garments, wraps, night garments and custom flat knit — so refills and replacements come from one place.

If a manufacturer's representative has recommended a specific pump to you, ask them those four questions too. Then call us and we will tell you honestly whether we are the better fit for your situation — sometimes we are not.

Very likely, yes — just not with the pump itself. We cannot service or supply garments for another manufacturer's device.

What we can do is everything around it. Most people using a compression pump also need daytime compression garments, adjustable wraps and night garments, and those are prescribed and billed separately from the pump. That is a large part of what we do, and it does not matter whose pump you own.

If your pump came from a manufacturer's representative, there is a reasonable chance nobody has measured you properly for garments. Call us and we will tell you what your plan allows.

It is the law that created a benefit category for doctor-prescribed compression garments. Before it, compression garments sat in an awkward gap — medically necessary, routinely prescribed, and frequently not covered as a distinct benefit at all. Patients paid out of pocket for the one treatment that actually manages the condition day to day.

Most insurers have since followed the Act, and prescribed compression garments are now far more widely covered than they were. There is more detail on our education page.

The allowances most plans work to are:

• Three daytime garments per affected area, every six months
• Two nighttime garments per affected area, every twenty-four months

Per affected area matters — if you have both legs affected, that is counted separately from one. Plans do vary, so we verify your actual allowance in writing before ordering rather than assuming.

No, and this is the single most common misunderstanding we hear.

The Act created a benefit for garments — stockings, sleeves, wraps, night garments. Pneumatic compression pumps are a separate category with their own device criteria, documentation and prior authorization requirements. Being approved for garments does not mean you are approved for a pump, and the reverse is also true.

Both are worth pursuing if you need them. They just take different paperwork, and we handle both.

We work with most insurance plans, and the honest answer for any specific plan is that we need to check it — coverage varies not just by carrier but by the individual policy.

Send us your information and we will verify your benefit for you in writing. There is no cost and no obligation, and you will know your actual out-of-pocket before anything is ordered.

Midwest Compression is not billing Medicare or Medicaid at this time. Cash pay is available for patients who do not fit insurance criteria, and HSA and FSA cards and all major credit cards are accepted.

We handle appeals. A denial is frequently a documentation problem rather than a genuine coverage decision — a missing detail on the prescription, a progress note outside the required window, measurements that were not recorded.

We go back to your provider's office to get what is missing rather than sending you back and forth between them and us. If it ultimately is not covered, contact us and we can determine whether you are eligible to buy direct.

Your prescriber decides this, and it is not a preference — the wrong level can be ineffective or genuinely harmful.

As a rough orientation: 15–20 mmHg is typically for mild swelling, tired legs and travel. 20–30 mmHg is the most commonly prescribed medical level, used for lymphedema, varicose veins and moderate venous disease. 30–40 mmHg and above is for more advanced venous disease, ulcer management and established lymphedema.

If your prescription does not specify, we will contact your provider rather than guess.

Ready-to-wear garments come in standard sizes. If your limb measurements fall within the size chart, they fit well, they are quicker to get, and they cost less.

Custom flat knit garments are made to your individual measurements. They are the answer when a limb is an unusual shape, when swelling is uneven, when there are deep skin folds, or when ready-to-wear simply does not fit — which is common in advanced lymphedema and lipedema. They take longer to arrive because they are made for you.

We carry both, across Juzo, Jobst, medi, circaid, Sigvaris and Solaris, so the recommendation is based on your limb rather than on what we happen to stock.

Here, in our private fitting suite in Richland, just outside Kalamazoo. Measuring and fitting is done by a Certified Compression Therapist.

We see patients from across the region — Kalamazoo, Portage, Battle Creek, Grand Rapids, Lansing, Jackson, Ann Arbor, St. Joseph, Benton Harbor, Muskegon and Coldwater among them.

8988 East D Avenue, Richland, MI 49083. Mon–Wed 9–3 · Thu 9–5 · Fri 9–1.

We measure the limb at a series of specific points, talk through what you will actually be able to get on and off by yourself, and check the fit against the garment you will be wearing every day.

For custom garments the measuring is detailed and takes real time, which is why we book those only once your prescription and provider documentation are on file and your insurance benefit has been verified. Send the paperwork first — we will confirm coverage and then call you to arrange a time.

Juzo, Jobst, medi, circaid, Sigvaris and Solaris for garments and wraps, and Bio Compression Systems for pneumatic compression pumps.

Because we carry all of them, healthcare providers can choose their preferred brand and product rather than being limited to a single line. See the full range we carry.

Fax the prescription and supporting documentation to 800-886-4201, or order digitally through Parachute Health at parachutehealth.com/midwestcompression.

We contact your patient within two business days, verify their benefit, handle the prior authorization, and keep you updated. More for providers here.

A signed prescription, a progress note from the past six months documenting the diagnosis, and current measurements if you have them. For pumps, plans generally also want evidence that conservative treatment has been tried.

Every measurement form, sizing chart and order form we use is in the Forms Center — 143 of them, grouped by manufacturer, with a search box. If a form you need is not there, call and we will send it to you the same day.