INSURANCE REIMBURSEMENT TERMS & CONDITIONS

Last Updated: 2025

By requesting a medical receipt or pursuing insurance reimbursement through
Caring & Comfort, you acknowledge and agree to the terms outlined below.

1. Insurance Coverage Limitations

Coverage varies based on individual insurance policies. Even when a cranial prosthesis appears as “fully covered,”
reimbursement may be capped, partially approved, or denied based on plan rules, exclusions, or insurer discretion.

2. Client Financial Responsibility

You are responsible for all non-covered amounts, including:

• Any remaining balance beyond insurance reimbursement
• Upgrades in customization such as color, density, or length
• Professional services including fittings, styling, adjustments, or accessories

Any unpaid balance after insurance processing remains owed by you.

3. Prepayment and Refunds

If you prepaid, any approved and received insurance reimbursement will be refunded to you within
30 days. If reimbursement is partial or denied, the remaining balance is
non-refundable and remains your responsibility.

4. Deposits and Production Commitment

If a deposit was made instead of full payment, once production or allocation begins, the order and any associated
insurance claim are non-cancelable. Deposits are non-refundable due to the medical, customized nature of the product.

5. Claim Submission Requirements

Claims may be filed by you or with Caring & Comfort’s assistance. Regardless of who submits the claim, you are responsible for:

• Providing accurate and complete information
• Responding to insurance inquiries
• Following up directly with your insurance provider

Caring & Comfort does not guarantee claim outcomes, processing timelines, or reimbursement amounts.

6. No Guarantee of Insurance Approval

All coverage decisions are made exclusively by the insurer. Caring & Comfort does not control nor guarantee:

• Approval status
• Eligibility determination
• Final reimbursement amount
• Timestamps or processing timelines
• Request outcomes or appeal decisions

7. Acceptance of Terms

By submitting insurance information, requesting a receipt, or con