Medical Reimbursement

If your doctor feels that proper breathing would help you medically, ask him/her to write a prescription for you – usually a note on a prescription blank from your doctor is all you need for reimbursement by your health plan.  If your insurance provider questions it or denies the purchase, ask your doctor to sign the form on this page for you.

Health insurance plans typically cover the cost of goods and services that are requested by a physician – it is worth a try as insurance plans vary widely and you may be covered.

I have provided two versions, one blank and one filled in. . .some doctors want to fill in their own forms and some find it convenient if the form is ready for their signature. Either way, this is a conversation you should have with your physician.

Here’s what the form looks like; below are PDF versions you can download and print:

Here are the two versions you can download-click on either:

           CMN1         CMN2


Page last updated August 27, 2017