As people age, they often require durable medical equipment to manage or live with their condition. They may require a wheelchair or a bath chair. The equipment can be expensive, but some of it may be at least partially covered by Medicare. However, knowing what is covered, how to get it covered, and how much will be paid can be complicated.
Below are 4 tips that can help caregivers when purchasing durable medical equipment.
#1: Know What is Considered Durable Medical Equipment
According to the National Council on Aging, Medicare may cover durable medical equipment under these conditions:
- The equipment must be durable, which means it can be used multiple times.
- The equipment must be expected to last for at least three years.
- It must be designed specifically to aid with a medical condition or injury.
- It must be suitable for home use.
Some examples of durable medical equipment are:
- Wheelchairs.
- Scooters.
- Walkers.
- Portable oxygen equipment.
- Hospital beds.
- Some other types of equipment may also qualify, such as orthotics and prosthetics.
#2: Ask if the Provider Accepts Medicare
Not all businesses that sell durable medical equipment accept Medicare as payment. Some may not accept the particular plan your aging relative is on. When determining where to purchase equipment, caregivers should first ask the provider if they accept Medicare. Since Medicare Advantage plan users may be required to use providers from a list for equipment to be covered, it’s important to know if the provider is part of that list.
#3: Know When You Must Change Suppliers
Some kinds of durable medical equipment are rented from suppliers, such as oxygen. If the supplier’s contract with Medicare runs out, the senior may have to change suppliers under certain circumstances. The rules concerning this matter are complicated and have to do with whether the provider chooses to be grandfathered. When in doubt, the senior or their caregiver should contact Medicare to find out.
#4: Know the Requirements
Certain conditions must be met before your aging relative’s durable medical equipment is covered by Medicare. First, their medical provider will need to sign an order that indicates the equipment is necessary for treatment or for the senior to function because of a condition. Second, the senior must have a face-to-face appointment with their doctor within 6 months before prescription for the equipment is written. Finally, you must use a provider who is covered under Medicare. Again, caregivers can contact Medicare to obtain information about eligible providers.
Sources: https://dailycaring.com/buying-medical-equipment-make-sure-to-ask-4-key-questions/
https://www.ncoa.org/wp-content/uploads/DME-Consumer-Slides.pdf
https://www.cms.gov/Outreach-and-Education/Outreach/Partnerships/Downloads/BeneficiaryGuide.pdf