It’s as easy as 1, 2, 3!

	Contact your healthcare provider to obtain a prescription for the EarPopper EP-2100.
	Print out this form for your pharmacist.
	Take your prescription and the form to your pharmacist to be filled. PLEASE NOTE: To fill the prescription, the pharmacy will need to order the device and should have it available within 24 hours.

* Price in the USA. Pricing may vary in other countries.

Insurance Reimbursement:  The EarPopper EP-2100 sells for approximately $200*, however, your cost may vary depending on your insurance coverage, co-pay amounts and the individual pharmacy.

To support your request for reimbursement, ask your prescriber for a letter of medical necessity. Typically, this letter should include patient information and an explanation of your condition.  Other supporting documentation may also be required.

To view a sample letter of medical necessity, click here:

To download the letter template, click here:

Micromedics can provide you with an information package that contains clinical studies you can present to your insurance company to assist in qualifying the device for reimbursement.