Medicare - how do you get backup supplies

[ghstudio]

I would like to keep a backup of various supplies (mask,nasal cushion,hose, filters) so that when they wear out or become disfunctional, I can replace them without a wait.  When I call my supplier, they ask me questions required by medicare:  Is your mask torn, discolored? Is hose torn, discolored? and so on...and then they ask a final question that asks "do you have any of these supplies on hand unopened?  Since I am trying to get recommended backups, I must essentially answer each question inaccurately, or they won't send me the supplies.

I actually order supplies well beyond the medicare recommended replacement periods, but I still get the same questions and have to give the same answers.

Does this make sense to anyone?

[PaulaO2]

That's just weird. Medicare has a replacement schedule and, as far as I know, it doesn't mean your supplies have to be dead.

I need to call mine to get supplies. If I remember to do it, that is. Curious as to what they ask me.

[OpalRose]

Yep, I get the same drill when I call my DME.

I wanted a replacement water chamber.  They wanted to know what was wrong with mine.

I asked for a new heated hose.  They asked if my current one had leaks.  

I asked for replacement nasal pillows.  They asked me if something was wrong with my current pillows.

I then asked them why they keep badgering me with the same questions every month.  
They said it is Medicare policy that they ask.

I don’t buy into their crap, but you sort of have to play along if you want insurance to pay.

[JesseLee]

I get the same questions. I don't know if that's a requirement from Medicare because the automated system does all the asking of questions. When I get a real person calling or when visiting the DME, they simply ask if I want the supplies available per the schedule.

I compare it to unemployment's automated system that has to ask the job search and availability questions. The difference being the unemployment's automation gets answers as sworn statement and carry a penalty for false answers obviously because of fraud. The unemployment office will also collect those answers on a signed form which serves as an affidavit.

[stanleydean]

During 18 years and 5 DMEs I was only asked this type of question one time having to do with a new CPAP machine when I was due according to the schedule. I told the DME that I had to keep the filter in place with a rubber band and she said "if ti's held together with rubber bands you need a new one". Otherwise, I just email my DME when the schedule shows that I am due for supplies, they get approval from my insurance (Medicare Advantage) and I pick up the supplies. In a year I will be eligible for a new machine and a new O2 concentrator, it'll be interesting to see how that goes. It is important to build up a stash of supplies to avoid interruptions.

If you are otherwise satisfied with your DME you can usually work around the questions. Otherwise, you could consider checking with a different DME if that is an option in your area. It's crazy that there is so little consistency from one DME to another. 

Stan

[SarcasticDave94]

I could see their questioning if you're asking for supplies off schedule. Otherwise, doesn't make sense. FWIW my DME asked the usage question (literally Are you using your ASV?) and that's about it. I do believe my schedule emulates Medicare for replacement parts.

[OpalRose]

This is the usual replacement schedule.  Not sure if it is complete or up to date.

A7034  CPAP Mask                      (Every 3 months)
A7035  CPAP Headgear               (Every 3-6 months)
A7036  CPAP Chin Strap              (Every 6 months)
A7037  CPAP Tubing                   (Every 3 months)
A7038  Disposable Filter              (2 new filters every month)
A7039  Non-disposable Filters      (1 new filter every 6 months)
A7030  Full Face Mask                 (Every 3 months)
A7029  Nasal Pillows                   (2 per month)
A7046  Humidifier Chamber        (Every 6 months)
E0601  CPAP                             Generally, 3 to 5 years.)

[sarah]

I've been getting those questions from my DME in just the last year. I assumed they were now documenting orders better to protect themselves, since they had previously been accused of pushing supplies.

[stanleydean]

This is the usual replacement schedule.  Not sure if it is complete or up to date.

A7034  CPAP Mask                      (Every 3 months)
A7035  CPAP Headgear               (Every 3-6 months)
A7036  CPAP Chin Strap              (Every 6 months)
A7037  CPAP Tubing                   (Every 3 months)
A7038  Disposable Filter              (2 new filters every month)
A7039  Non-disposable Filters      (1 new filter every 6 months)
A7030  Full Face Mask                 (Every 3 months)
A7029  Nasal Pillows                   (2 per month)
A7046  Humidifier Chamber        (Every 6 months)
E0601  CPAP                             Generally, 3 to 5 years.)

That's pretty much what I see from my DME except my current DME is providing one Full Face Mask plus one replaceable cushion every three months. I clean my mask daily using a disposable wipe and can easily get three months without the extra cushion but it's nice for backup. 

Stan

[SarcasticDave94]

Mine almost follows that schedule. I get several disposable filters per order, random number. Mask cushion similar. Sometimes 2 or 3 at a time.