ThermApparel UnderCool Vest for Lupus Heat Sensitivity Relief – 2 Hour

Insurance Coverage FAQs

Do You Accept HSA/FSA Debit Cards?

Yes! We accept HSA/FSA debit cards for all products on our site. If your payment is denied, you may not have the available funds. If you do have funds, please contact your insurance company to determine why it was denied.

Is UnderCool Covered by Insurance?

Yes. This is for someone who doesn’t have an HSA/FSA account and would like their insurance to cover it directly.

These cooling vests may qualify for insurance coverage as DME (Durable Medical Equipment).

Most insurance providers require proof from your doctor that you need a cooling vest for medical reasons. Meeting the requirements from an insurance provider can be tricky but at Lupus Health Shop we try to make it easy. Follow the steps below and you can start the authorization process.

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

• Be patient with the approval process as most insurance providers require weeks to come to a decision. In most cases, insurance providers will reject your claim it is better to have your doctor’s office insurance liazon call on your behalf. Either way, if you’re rejected you will need to submit an appeal to reverse the rejection. 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 UnderCool. Please contact your insurance provider before you purchase to make sure they will accept this use of your funds. Then make your purchase on Lupus Health Shop.

Please note, Lupus Health Shop is not responsible for your prescription, claim or denial and we can not guarantee that these steps will work as each insurance company, situation and patient are different. Here are a few tips to ensure the process goes as smooth as it can:

Please follow the steps below:

1. 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.
2. While on the phone with your providers office, ask to speak to the person who takes care of insurance claims. Let them know you are wanting to purchase a cooling vest because it helps with heat sensitivity from your chronic condition. ThermApparel is a registered DME vendor. The healthcare code to classify UnderCool is E1399. Because of this code, some insurance providers may only need a letter of medical necessity written by your doctor and an invoice from us (contact [email protected] for the invoice).
3. If they cover it, awesome! Ask how reimbursement works. We can’t submit the paperwork for you so you will have to get approval from the insurance company first, then purchase an UnderCool according to their acceptance and reimbursement rules. Insurance companies will not reimburse you for UnderCool if you purchase before their approval.
4. If they deny it and say UnderCool is not covered as a durable medical device, 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.
5. Ask your insurance provider what is the financial threshold for needing prior authorization for your plan. Let your insurance provider know that UnderCool costs less than $500 as this is a general threshold for needing prior authorization. Because of this, some providers will automatically approve your UnderCool purchase. 
6. If step 6 doesn’t work, we can supply you with a Letter of Network Deficiency and an invoice. Send us an e-mail at [email protected] and fill us in 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.
7. Get a Letter of Medical Necessity from your doctor. You can download a template here for your doctor to alter for your specific needs.
8. Submit all three letters, prescription, and invoice to your insurance provider and wait. Be persistent and nice and follow up consistently. Be prepared that they will most likely decline your claim.
9. If they accept it, awesome! Clarify with your insurance provider how reimbursement works before you purchase UnderCool and then purchase at Lupus Health Shop. 

If they deny your claim, there are still things you can do. Try to file an appeal.

Tips for Filing an Appeal Letter for A Cooling Vest
The National MS Society publishes a Health Insurance Appeal Letter Toolkit for Clinicians. It’s ok if you are not a clinician, you can still use the template 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 Letters.

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

• Clinical and Immunological Effects of Cooling in Multiple Sclerosis (P.K. Coyle, L.B. Krupp, C. Doscher)
• A randomized controlled study of the acute and chronic effects of cooling therapy for MS. (SR Schwid, MD Petrie, R Murry)

Although these are for MS, lupus shares the same exact symptoms of heat intolerance which is why your doctor’s note and insurance liaison is just as important in this conversation with your insurance company.

1. Create your own Cooling Vest Appeal Letter based on the template from the Health Insurance Appeal Letter Toolkit for Clinicians.
2. Submit the Cooling Vest Appeal Letter and the 2 studies via e-mail, snail mail, carrier pigeon etc. to your insurance provider.
3. Wait to hear back from the insurance company, but be persistent and nice and follow up consistently.

UnderCool FAQs

Unisex Sizing Guide:
ThermApparel recommends ordering a size smaller than your usual T-shirt size.
(If you wear a large T-shirt, a medium UnderCool will fit best.)

What Does This Come With?

• 1 UnderCool vest
• 1 set of cooling packs

What is UnderCool?

UnderCool is a lightweight garment designed to keep you cool and comfortable in any situation. The unisex design can be worn under virtually anything. Unlike other cooling garments, you can wear UnderCool directly on your skin. With UnderCool you can stay cool and look it too!

How Does UnderCool Work?

UnderCool uses multiple layers to maximize cooling effect and duration. The garment is made of comfortable wicking fabric to keep you cool and dry and features mesh panels for maximum breathability. The lightweight and flexible phase change material packs are reusable cooling materials for the garment. UnderCool features velcro for easy on and off application and adjustable straps for the best fit.

What is Phase Change Material (PCM)?

Phase change material (PCM) is a category used to describe a wide variety of materials capable of storing and releasing large amounts of energy during the melting/freezing process.

How Do PCMs Work?

PCMs are substances that absorb and release thermal energy during the process of melting and freezing. In the case of UnderCool, the PCM slowly absorbs your heat over time to keep you cool and comfortable, even in humid environments!

Are PCMs Safe?

Not all PCMs are created equal. ThermApparel uses a PCM which is USDA certified bio-based. That means no dangerous oils or hard to clean paraffin waxes.

What Does USDA Certified Bio-Based Mean?

Back in 2002, the United States Department of Agriculture (USDA) initiated the USDA BioPreferred® program as part of the Farm Bill. The Program is an accreditation for products with demonstrated biobased content – meaning the ingredients come from renewable biological sources.

The USDA Certified Biobased product label actually lists the percentage of biobased content in each product. The move was made to help consumers identify biobased products and increase the demand for renewable commodities. 

So why buy biobased? There are a lot of good reasons why the USDA is promoting biobased products: Biobased products replace the need for many petroleum-based products, reducing our dependence on fossil fuels. By reducing the need for mining and burning of fossil carbon, we can avoid the release of new carbon into the atmosphere and help control climate change.

How Long Does it Take to Recharge the Cooling Packs?

The cooling packs will freeze in any environment under 70˚F / 21˚C.

• Using water with ice(bottom of a cooler): 20 minutes
• Freezer: 45 minutes in the Freezer (with or without vest)
• Refrigerator: 60 minutes
• If left on a cold surface in a cold room under 70˚F / 21˚C: 10-12 hours

Please note all recharging times are approximate.

Can I take UnderCool On a Plane?

Possibly. By being prepared with the correct TSA guidelines ahead of time. Read the tips and guidelines we have put together for you.

Returns & Exchanges

As stated in the ThermApparel User Guide, you have 30 days from purchase to return or exchange your purchase if the vest and cooling packs are still in new condition. ThermApparel has the right to inspect each return. We want you to be completely satisfied with any product you purchase from us, if for any reason you’re not, please call Lupus Health Shop  at 716-427-0536 we are happy to help.

Garment Warranty

ThermApparel offers a one year warranty against any defects in materials and/or workmanship in our garments. We will repair or replace any garment, at ThernApparel’s sole discretion, within that time. (Our warranty does NOT cover over-stretched garments from improperly drying or hanging garments.)

Any use of garments other than their intended purpose as stated in the Guide voids the warranty.

Cooling Pack Warranty

ThermApparel offers a one year warranty against any defects in materials and/or workmanship in our cooling packs. We will repair or replace any cooling pack, at ThernApparel’s sole discretion, within that time. (Our warranty does NOT cover intentional slices or rips in the cooling pack packaging.)

Any use of the cooling packs other than their intended purpose as stated in the Guide voids the warranty.

Damaged Product

Please contact us if your product is received damaged or defective and we will make it right! If your product is received damaged in shipping, keep all packing materials and report the damage to Lupus Health Shop’s Customer Service at 716-427-0536. 

If you received a damaged Undercool garment:

1. Please call us at 716-427-0536 to obtain a Returned Goods Authorization number (RGA).
2. Please keep all of your cooling packs. They will be compatible with your new UnderCool, and this helps to keep the cost of shipping low.

3. Please return the UnderCool only along with your receipt to:

Lupus Health Shop
P.O. Box 427
East Amherst, NY 14051
Attn: Damages

4. Please mail the UnderCool back to us via the most convenient and cost-effective method for you (US Mail, Fed Ex, or UPS). Please include your receipt and indicate your desired vest size.
5. Our staff will send you a new UnderCool as soon as we receive the returned product. If you have any questions, please call our customer service at 716-427-0536.

If you received a damaged cooling pack:

1. Please call us at 716-427-0536 to obtain a Returned Goods Authorization number (RGA).
2. Please keep your UnderCool garment and all of your undamaged cooling packs, this helps to keep the cost of shipping low.

3. Please return the damaged cooling pack(s) only along with your receipt to:

Lupus Health Shop
P.O. Box 427
East Amherst, NY 14051
Attn: Damages

4. Please mail the damaged cooling pack(s) back to us via the most convenient and cost-effective method for you (US Mail, Fed Ex, or UPS). Please include your receipt and indicate the damaged area.
5. Our staff will send you new cooling pack(s) as soon as we receive the returned product. If you have any questions, please call our customer service at 716-427-0536.

Product Repairs

We want you to be completely satisfied with any product you purchase from us. If you encounter a problem with your product that falls within our warranty we will repair or replace the product free of charge.

To obtain warranty service:
1. Please call our Customer Service at 716-427-0536 to obtain a Returned Goods Authorization number (RGA).
2. Please return the product along with your receipt to:

Lupus Health Shop
P.O. Box 427
East Amherst, NY 14051
Attn: Damages

3. Please return the product along with your receipt. Please include your phone number, where you purchased it from, and an explanation of the problem.
4. Upon receipt, we will determine cause of failure and will repair or replace (at our discretion) your product and return it to you, postage paid.