Cost & Insurance Coverage for the Codex Virtual Program

💰We understand that cost is a key consideration when starting a new health program. This article will help answer common questions like:

• Is this covered by insurance?
   
• What is covered?
   
• What if I have a cost?
   

🏥 Is the Program Covered by Insurance?

In many cases, yes — the Codex Virtual Program is typically covered by insurance, including Medicare and most commercial insurance plans. However, because we work across multiple states and insurance plans, coverage and out-of-pocket costs may vary based on your:

• Insurance provider
   
• Specific plan
   
• State of residence
   

✅ What’s Usually Covered

Most patients pay little to nothing out of pocket. If you have commercial insurance, it may even cover the program before you meet your deductible.

This often includes:

• 💡 Use of the Codex app
   
• 🩺 Telehealth visits with lifestyle coaches
   
• 📦 Devices such as blood pressure cuffs, glucometers with your first month* of glucose test strips, and weight scales
   

If you have Medicare without a supplemental, you will have a 20% copay

If you have Medicare & a supplement plan, the program is covered at no cost to you!

*After your first month, ongoing test strips must be obtained by the patient. 

💬 What Happens If I Do Have a Cost?

If it turns out your insurance does not cover the program, or if there’s a copay involved, you have options:

1. Continue if you're comfortable with the monthly cost
   – If you’re okay with the out-of-pocket expense, you’re welcome to stay enrolled.
    
2. Ask about self-pay options
   – Some healthcare providers offer discounted self-pay options. Contact us for more information.
    
3. Financial hardship support
   – We may be able to connect you with a financial assistance team at your organization to cover the monthly cost. Contact us to explore this option.
    
4. Unenroll from the program
   – If you decide not to continue, Codex will cover the cost of your bill.
    

🧾 Want to Check with Your Insurance?

You’re welcome to contact your insurance provider directly to ask about coverage. Here's what to tell them:

“I’m participating in a remote patient monitoring program through my doctor and would like to understand if it’s covered under my plan.”

⚠️ Note: Your insurer may not recognize the name "Codex Health" — and that’s okay. Billing is usually submitted under your doctor’s office, not directly by Codex.

You can also give your insurer these billing codes we often use:

• 99445
• 99453
• 99454
• 99457
• 99458-1
• 99458-2
• 99470
   

📌 Not all codes are billed every month — and some are only billed once.

📞 Still Have Questions?

We’re here to help! Contact us at support@codexhealth.com or +1 (650) 449-6616