Patient FAQs

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 Provider Forms.

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.

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.

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 Provider Forms — 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.

Yes. Every compression garment and pump order requires a prescription from your treating provider. Your provider sends the order to us directly — through Parachute Health, by secure fax to 800-886-4201, or by secure email to customersupport@midwestcompression.com.

It is, and this is a good question to ask. Providers send compression orders to us directly after your appointment, so our call is often the first you hear of it. You are welcome to look us up at MidwestCompression.com or call us back at (800) 883-1549 to verify before sharing any information.

If you do not recognize the ordering provider, tell us. We will not process an order you do not recognize.

• Ready-to-wear garments — about 2–3 weeks once processing is complete
• Custom garments — about 4–6 weeks
• Compression pumps — about 4–6 weeks

Most insurance plans now require prior authorization, which adds 7–14 days before the order can be placed.

Prior authorization is your insurance company's approval of the item before we are allowed to bill for it. We submit your prescription and clinical documentation, and the plan reviews it — typically 7 to 14 days.

We cannot shorten this window, but we can prevent delays by submitting complete documentation the first time. If your plan asks for something additional, we will contact your provider directly.

Four things make the biggest difference:

• Make sure both your physician and Midwest Compression have your current insurance. If you have secondary coverage, we need that too.
• Send us any address or phone change right away.
• Complete the payment link when it arrives.
• Sign the electronic paperwork as soon as you receive it.

Email changes to customersupport@midwestcompression.com.

The signature link usually arrives within 1–2 business days of your welcome call and is required before anything ships. If you cannot find either message, email customersupport@midwestcompression.com and we will resend it.

Midwest Compression will send you a text asking you to OPT IN. Please choose OPT IN so we can send SMS updates on your order. We will contact you if we need additional information or if you have a patient responsibility due.

If it has been 14 days and you have not heard from us, email customersupport@midwestcompression.com or text 517-657-5223.

Order status, tracking, paperwork reminders, and your secure payment link. Never marketing. Please confirm we have your mobile number — a landline cannot receive the opt-in message, and without the opt-in the updates will not reach you.

To your home address, unless your provider asked us to ship to their clinic. You will receive a tracking number when the order ships. Please confirm apartment or unit numbers with us so nothing is delayed in transit.

Email customersupport@midwestcompression.com or text 517-657-5223 with your name, date of birth, and what changed. Please also tell your ordering provider — an insurance card that is current with us but out of date at the clinic will still stall the order.

We send order updates by text message, not by phone. Every stage — documentation received, benefit verified, prior authorization submitted, order placed, shipped — goes out as a text, so you have it in writing and can look back at it.

Call 800-883-1549 for anything urgent during business hours. For a routine status check the text thread is faster and more accurate than we could be on the phone.

Usually, yes. Since January 2024, most insurance plans cover compression garments as a durable medical equipment benefit for patients with a qualifying lymphedema diagnosis. Compression pumps have long been covered.

Coverage still varies by plan, so we verify your benefits before your order ships and tell you your expected cost in writing.

Your insurance applies deductibles and coinsurance to compression items just as it does to a doctor's office visit. This is your plan's cost share — it is not a fee from Midwest Compression. Please check your insurance benefits for DME (durable medical equipment).

Most plans pay a percentage of the approved amount once your deductible has been met, and you are responsible for the rest. We verify your benefits and tell you your estimated share before the order is placed.

We verify your benefits before the order is placed and text you a secure link showing your estimated patient responsibility.

This figure is an estimate based on what your insurance told us that day. If your plan processes the claim differently, we will let you know before anything changes.

If you carry a second plan — a spouse's plan or a supplemental policy — it can significantly reduce or eliminate what you owe. Missing secondary coverage is one of the most common reasons a patient is quoted more than they should be.

Please check your wallet for a second insurance card and send us the plan name, member ID, group number, and policy holder before your order is placed.

We bill most major plans. Text the exact name of your plan, along with your name and date of birth, to 517-657-5223 and we will confirm coverage. Verification typically takes a few days.

Your patient responsibility is collected up front, before the order goes to the manufacturer. This is standard for durable medical equipment and protects you from an unexpected bill after delivery, particularly on custom items that cannot be returned.

Tell us — there are more options than paying in full or cancelling:

• Split it into payments. We can set up a payment plan.
• Hold the order. Later in the year more of your deductible may be met and your portion could be lower. We will check back on a date you choose.
• Ask about assistance. Email customersupport@midwestcompression.com to ask what may be available.

We cannot waive or discount an amount your plan has set as your responsibility, but we would rather find a way than lose the order.

Yes. HSA and FSA cards are accepted, and we issue receipts you can submit to your insurance yourself for possible reimbursement. Retail items are available at midwestcompression.com/shop; for other cash purchases, email customersupport@midwestcompression.com.

Patient-pay orders are paid in full before the order is sent to the manufacturer.

Coverage is never a guarantee of payment. If a claim is denied after a garment has been manufactured — for missing clinical documentation, an expired prescription, or a non-covered diagnosis — you are financially responsible for the billed amount.

This is exactly why we hold orders until documentation is complete. It is not us being slow; it is us protecting you from a bill.

Let us know — timing can change what you owe. We will look at both plans and help you decide when to place the order. Please send us the new plan information as soon as you have the card.

Contact us at customersupport@midwestcompression.com and ask about assistance. We would rather have the conversation than have you go without compression.

Tell us what you can manage. Some manufacturers run patient assistance programs, and in some situations there are other routes worth trying. Nothing is promised, but nobody should quietly give up on treatment because of cost without asking first.

Most insurance plans allow three sets of daytime garments every six months and two nighttime garments every two years, per affected body area.

Bandaging supplies, liners, zippers, and padding are covered as medically necessary with documentation.

Out-of-pocket cost applies per set — two sets is roughly double the cost of one, three sets roughly triple. If you have no out-of-pocket amount, additional sets cost you nothing.

Would you like to add another set or two? If so, we will adjust the paperwork with your provider.

Garments have to be washed regularly. With only one set, there are days you go without compression — and skipped days let swelling build back up.

• Rotating between sets extends the useful life of each one.
• The allowance resets every six months and unused allowance does not carry over.
• Two sets is the most common choice: wear one while the other is washed.

Compression begins to break down after about four to six months of regular wear. Once a garment stretches out it is no longer delivering the pressure your provider prescribed, even though it still looks fine.

Text your name and the item you need to 517-657-5223, or email customersupport@midwestcompression.com, and we will review your eligibility. Review typically takes a few days. Deductibles and coinsurance apply to replacements the same way they did to your first order.

Replacements outside the normal schedule are allowed with proper documentation. Contact us at customersupport@midwestcompression.com and explain what happened; we will tell you what your plan needs.

For ready-to-wear leg garments, calf circumference at the widest point and ankle circumference at the narrowest point. Measurement forms are at midwestcompression.com/forms.

Send measurements with the product name to customersupport@midwestcompression.com and we will recommend a size.

If your measurements are more than a few months old, or your limb has changed noticeably, we will ask for new ones before ordering.

Fittings are by appointment only. Request one on our contact page or email customersupport@midwestcompression.com and we will help you find a time.

Flat knit garments are knitted row by row to your exact measurements. They are prescribed for disproportionate limbs, severe swelling, or dimensions outside standard sizing, and we dispense them from CircAid, Juzo, Medi, and Sigvaris.

Because each one is made for a single person, it has no resale value — which is why custom garments take longer, require a certified lymphedema therapist's measurements and progress note, and cannot be returned or cancelled once production begins.

Contact us right away — do not keep wearing something that cuts in.

• Custom garments carry a 14-day fit guarantee. Notify us in writing within 14 calendar days of delivery with updated measurements from a certified lymphedema therapist, and the manufacturer will alter or remake the garment at no additional charge. Manufacturers remake when the corrected measurement differs by more than 3 cm; criteria vary by brand.
• Ready-to-wear garments follow our standard 30-day return policy.

Email customersupport@midwestcompression.com with your order number and photos.

For custom orders, no. We order a single garment first to confirm the fit. Once fit is verified, we place any additional garments your prescription calls for. It adds a little time and it prevents a full order of garments that do not fit.

Many patients qualify based on diagnosis and symptoms — most commonly a lymphedema diagnosis. We can check for you. Email customersupport@midwestcompression.com.

Most insurance plans replace pumps every five years. If your pump is older than five years, or is no longer working the way it should, we can send paperwork to your provider to start the conversation. There is no obligation.

It is a device you use at home. You slip on a sleeve that connects to the pump, and it gently inflates and deflates in a wave pattern to move fluid out of the limb. Most patients use it for about an hour a day, sitting or lying down comfortably.

Instructions ship with the device, and setup videos are at midwestcompression.com/instructional-videos.

Yes, in certain circumstances. Email customersupport@midwestcompression.com or use the contact form on our website to ask whether a rental is appropriate for your situation.

Email us to request a Return Authorization Number and include the model number and serial number from the machine, along with your name, address, phone, and email. We will email return instructions once the authorization is issued.

Repairs can take up to 10 days. The patient is responsible for shipping cost.

Yes. Pack it with protective padding in a small suitcase or duffel and label the bag “Handle with Care — Medical Equipment.” Pumps pass safely through airport X-ray machines. Contact us 14 days before you travel and we will provide documentation explaining the device.

Wash them before the first wear. Hand wash, or use a gentle cycle in a mesh bag with mild soap, and let them air dry.

Put daytime garments on first thing in the morning, before swelling builds up, and take them off at night — unless your provider told you otherwise. Nighttime garments are a separate product designed to be worn while you sleep.

Do not keep wearing it and do not try to stretch or alter it yourself.

Step-by-step videos are at midwestcompression.com/instructional-videos. You can also schedule training with us — email customersupport@midwestcompression.com.

No. We are a durable medical equipment supplier, not a healthcare provider, and we cannot give medical advice, interpret your diagnosis, or change your compression level. Questions about your treatment belong with your ordering provider or lymphedema therapist.

If you are having a medical emergency, call 911.

This order was prescribed by your doctor, so before you cancel, talk to us — a payment plan or holding the order until more of your deductible is met is often a better outcome.

• Ready-to-wear items may be cancelled by email before they ship.
• Custom items may only be cancelled before the manufacturer begins production. After that they cannot be cancelled or refunded.

Send cancellations in writing to customersupport@midwestcompression.com.

• Knit compression products (stockings, socks, arm sleeves, gauntlets, gloves) — returnable within 30 days even if worn. Must be laundered first or a $10 cleaning fee applies.
• Night garments and wraps — returnable or exchangeable within 30 days, unworn. Briefly trying them on for size is fine.
• Special order and custom items — not returnable unless there is a manufacturing defect.
• Trim-to-fit or customizable products — not returnable once worn or altered.

Full details at midwestcompression.com/returns.

Email us to request a Return Authorization Number and allow up to 5 business days for processing. Returns sent without authorization are not eligible for a refund, and you would be responsible for shipping to retrieve them.

• Shipping charges are non-refundable.
• You pay return shipping, except on defective products.
• Refused or returned-to-sender packages incur the original shipping cost plus a 20% restocking fee.

Tell us within 14 days — a broken seam, the wrong compression class, or dimensions that do not match the order form. It will be remade or replaced at no charge under the manufacturer's warranty. Defects found after normal wear has begun fall under the manufacturer's standard warranty, which varies by brand.

Email customersupport@midwestcompression.com within 7 days of delivery with your order number and photos of the garment on the limb. That seven-day window matters — manufacturers will not consider a fit exchange after it closes, and custom items are not returnable unless they are defective.

Do not wear the garment while you wait to hear back. A garment that has been worn cannot be exchanged.

• Website — MidwestCompression.com
• Secure email — customersupport@midwestcompression.com
• Text — 517-657-5223
• Phone — (800) 883-1549
• Secure fax — 800-886-4201

Please allow up to 48 hours for a reply. We are closed weekends and holidays.

Monday–Wednesday 9:00–3:00, Thursday 9:00–5:00, Friday 9:00–1:00 Eastern.

8988 East D Avenue, Richland, MI 49083. Visits are by appointment only.

Send attachments through our secure email, customersupport@midwestcompression.com. Please do not send protected health information through website chat or social media. For anything involving your medical records, contact us directly and we will arrange secure communication.

Pneumatic compression pumps from BioCompression, and compression garments from Medi, Juzo, Sigvaris, CircAid, and L&R — including ready-to-wear and custom flat knit, night garments, wraps, sleeves, and gauntlets. We also carry cold compression for shoulder, back, knee, and ankle.

Only if they are listed as an authorized representative on your file. If you would like to add someone, tell us and we will note the authorization. Until then, privacy rules prevent us from discussing your order with anyone else.

If the order was placed on Parachute Health, use the secure Parachute message platform. Otherwise, secure email customersupport@midwestcompression.com or secure text 517-657-5223. Please allow up to 48 hours for a reply.

New referrals: Parachute Health, secure fax 800-886-4201, or secure email — include patient demographics, diagnosis, and signed progress notes.

Visit MidwestCompression.com for educational resources, product information, clinical studies, instructional videos, and support. Our clinical FAQs answer questions about pump pressure, contraindications, and lymphedema care.