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Medicare and DME
#1
Medicare and DME
I'm in the "buying" period with a new ResMed Auto 11. I get equipment ads from my vendor, but they show very high list prices. I do not understand what part of purchases might be covered by my Medicare.

Can I get some compensation from Medicare for things like filters, tubing, masks, humidifiers, etc.? Can I purchase from other legitimate vendors and still get compensated? How can I become better informed about the whole process?


Unfortunately, I do not particularly trust my local vendor to advise me. They are a local office of a very large organization. They seem much more oriented to profit-making than to support.
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#2
RE: Medicare and DME
Medicare will pay for 80% of the cost (the amount reduced from retail) and if you have a secondary insurance they might pay the 20%. We have Medicare and Tricare for Life and all costs for machine and supplies paid 100%. However they do not reimburse but you have to go through a DME. The local DME you mentioned would make tons more money selling retail to you as those vendors who are Medicare approved have to take what Medicare pays. I see you live in Hawaii and may be limited in what DME you have to use. I have actually called the Medicare customer service and had questions answered. If you are forced to deal with just one vendor (make certain any vendor is Medicare approved) you may have to suck it up and talk to them--in person if possible, but phone OK, but take down names. I'm assuming you do have a current prescription for the new Resmed?
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#3
RE: Medicare and DME
Thank you! Yes, all my "papers" are in order. I guess I'll put on my suit of armor and go talk to them. Have you ever worked with online ordering? Can it be reimbursed like the original provider?
Thanks
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#4
RE: Medicare and DME
Screenshot below for when I started out on CPAP, what the DME supplied, and what Medicare paid and I may be billed (I have a Medicare supplement plan and ended paying zero). Note that the CPAP device itself is a rental in this Medicare statement and the rental period is 13 months. You may have a 3 month 'trial' period that you'll need to show compliance that you are using the device.
I purchased my CPAP through a brick & mortar DME supplier. For reference this was for a Dream Station 1 back in 2020.

https://www.medicare.gov/coverage/contin...re-devices

[Image: BxHMBYY.jpg]
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#5
RE: Medicare and DME
Hart Medical is my DME. Search for them. I am on Medicare plus supplement and all was covered since I had already covered my Medicare deductible. They do online ordering. They will need your Prescription.

They have been offering very reasonably priced A10 C2C AutoSets.
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#6
RE: Medicare and DME
Thank you very much. I hadn't thought about this approach. Is your supplier on the web? Is there any requirement to be physically near. I'm in Hawaii, and travel is a big issue.
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