Here’s the short answer: Your insurer may reimburse you for CEFALY, but it’s not guaranteed. Insurance coverage and reimbursement for CEFALY depend on your individual insurance provider and plan.
We’ll walk you through the process of finding out if CEFALY is covered by your insurance, and if it is, how to file a claim.
Questions? Just reach out to our Customer Support team.
How do I know if my health insurance covers CEFALY?
The best way to find out is to contact your insurer directly. We don’t recommend calling and asking “Does my insurance cover CEFALY?”, because your provider may not have the specific brand name on their list.
Instead, call and ask: “Does my plan cover durable medical equipment (DME) under HCPCS Code K1016?”
If your insurer says yes, then ask: “What documents do I need to submit a claim?”
If you are a veteran, CEFALY is covered through the VA healthcare system. Here’s how to obtain CEFALY through the VA.
Try CEFALY for Migraine Relief
How do I get insurance reimbursement for my CEFALY device?
Once you’ve confirmed that your insurance plan does cover durable medical equipment under HCPCS Code K1016, here’s what to do.
1. Gather the required documents. Ask your insurance provider which documents are needed to file a claim. These may include:
- Letter of Medical Necessity – This is a letter written by your healthcare provider that explains why CEFALY is essential for your migraine treatment.
- Insurance claim form – You can find this on your insurance provider’s website, or ask your insurer to send it to you.
- Copy of your CEFALY invoice – This is the email receipt that serves as your proof of purchase.
- HCPCS Code K1016 reference – Include this code in your claim submission.
2. Submit your claim.
- Send your completed claim form and supporting documents to your insurance provider.
- Keep copies of everything for your records.
3. Follow up.
- If you haven’t heard anything in 2-4 weeks, ask your insurer about the status of your claim and how long it will take to process.
What if my insurance provider denies my claim for reimbursement for CEFALY?
Remember that coverage and reimbursement for CEFALY depend on your individual insurance provider and plan, and are not guaranteed.
If your health insurer refuses to pay your claim, ask for a written explanation. Insurers have to tell you why they’ve denied your claim, and they must let you know how you can dispute their decisions. If you want to appeal, you have two options:
- Internal appeal: You can ask your insurance company to conduct a review of its decision. Learn more
- External review: You can take your appeal to an independent third party for review. Learn more
Your doctor may be able to help you appeal a denied claim.
Try CEFALY for Migraine Relief
What if my health insurance provider says they won’t cover CEFALY?
If your insurer doesn’t cover CEFALY, you may want to consider a different payment option.
- If you have an HSA/FSA account, you can use it to purchase the CEFALY device and/or electrodes. Both are approved HSA/FSA expenses.
- We also offer flexible payment plans through Affirm and PayPal Credit. Just select your preferred option at checkout.
- CEFALY offers a 90-day money back guarantee, so that you can return the device if you’re not able to get insurance reimbursement or if you don’t see the results you want.
Compared to prescription migraine medications that can cost $700-$1,000 or even more without insurance, CEFALY is a super-affordable migraine treatment. Once you get your CEFALY device, it’s yours to keep and use whenever you need it.
Which health insurance providers cover CEFALY?
As of 2025, CEFALY does not have contracts with commercial insurance company payors, Medicaid, or Medicare. However, CEFALY does have an HCPCS code: K1016. This code makes it easier to submit a claim for reimbursement to your insurance provider.
The CEFALY team is actively working with insurance providers to expand coverage for our migraine treatment devices. We’ll let our patient community know when we have contracts with specific insurance companies.
Why is it so difficult to get insurance coverage for migraine treatments?
Feeling frustrated? You’re not alone. Many, many migraine patients find that it can be challenging to obtain insurance coverage or reimbursement for their medical treatments.
“Unfortunately, because many people are unaware that migraine is a disabling neurological disease, insurance companies may not always recognize migraine and therefore do not cover some treatments,” the American Migraine Foundation explains in its guide to migraine and insurance.
If you have questions about how to get insurance reimbursement for CEFALY, we’ll do our best to help. Just reach out to our Customer Support team.
Try CEFALY Connected today for migraine management!
Try CEFALY for Migraine Relief
