Article by Jill Pinciotti

Durable medical equipment is covered by Medicare under their rules and regulations for DMEPOS-Durable Medical Equipment, Prosthetics, Orthotics and Supplies. This covers a wide range of equipment and supplies. Prosthetics and orthotics include things like prosthetic limbs, orthopedic shoes and special foot supports for people with leg, ankle and foot problems. Supplies include things like diabetic testing supplies, dialysis supplies, and some nutritive and medicinal products. Durable medical equipment also includes a broad range of equipment like adjustable beds, mobility scooters, wheelchairs, portable toilets, walkers and lift chairs covered by Medicare.

Medicare covers these types of equipment and supplies, but some of them, including some types of durable medical equipment, are only partially covered. Lift chairs, for instance, won’t be paid for fully by Medicare. A lift chair is a recliner chair with a special mechanism that lifts and lowers it electronically. That means someone with difficult getting up and down from a seated position can essentially lean back into the chair and be automatically lowered, and then lifted to the same height. He or she won’t have to struggle to rise from the chair or risk pain and injury to get into the chair.

Because medical necessity is required for a piece of medical equipment to be approved by Medicare, the plan won’t cover the full cost of the chair. The chair itself, after all, isn’t a medically necessary item. But the lift mechanism that provides the physical help is, in many cases. That portion of the cost of the chair will be covered by Medicare and the patient is responsible for the rest.

With any medical equipment, the process isn’t as simple as your doctor prescribing the equipment and you waiting for it to arrive. Some types of equipment, generally the most expensive types, require a Certificate of Medical Necessity and sometimes other forms and information from a doctor before they’ll be provided. These include things like lifts, oxygen equipment, wheelchairs and mobility scooters. Many supplies and other devices require extensive proof of necessity, and are sometimes challenged by Medicare before they’re approved. Each situation is different, just as each medical condition and need is different.

Recent changes to Medicare affect where you can get durable medical equipment like lift chairs and any items covered under Medicare’s list of DMEPOS items. In October of 2009, Medicare began requiring that suppliers of these items carry a surety bond and have certain accreditation. The action was taken to make sure the supplies and equipment were always the highest quality, and to minimize unscrupulous companies from committing fraud and filing unnecessary and sometimes false claims for Medicare reimbursement.

It’s important to know this because in many cases it’s necessary to purchase the equipment and then file for reimbursement from Medicare. Some items like lift chairs, for example, are usually purchased when the need arises rather than put off to wait for a Medicare approval. If you purchase equipment or supplies from an unbonded and unaccredited supplier, Medicare won’t reimburse you for any part of that purchase. Fortunately, because many companies rely on Medicare purchases for a large part of their business, those who didn’t already carry these requirements quickly acquired them. But make sure any company you use to purchase supplies and equipment is fully in compliance with Medicare rules so that you can be reimbursed properly.

About the Author

Jill Pinciotti is a technical writer for numerous retailers of medical supplies and mobility equipment, such as lift chair recliners.

Tagged with: Durable • equipment • getting • Medical • Medicare • Through

Filed under: Diabetes Testing Equipment

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