12-22-2017, 07:28 PM
(This post was last modified: 12-22-2017, 07:41 PM by Mosquitobait.)
RE: medicare questions?
The problem is that the rules are interpreted weirdly (they are NEW rules). The rules were supposed to apply to durable medical equipment, not the replacement supplies, but someone in the gubmint interpreted them strangely (why do non-medical people make these stupid decisions?).
This is the current Medicare replacement schedule.
CPAP Mask (Nasal, Full Face, Pillows, Etc.) – every 6 months
Nasal Replacement Cushion – Don't know schedule on this but pretty sure it's one per month
Pillows Replacement Cushion – two per month
Headgear – replace every 3 (many DMEs won't replace headgear only; they will only replace a complete mask unit)
Chinstrap – replace every 6 months
Tubing – replace every 6 months
Air Filter – two per month
Full Face Cushion – once a month
Water Chamber- every 6 months
Ok, that said, you should have zero guilt getting these supplies the first year. You NEED backups. Once you have backups, then it's up to you how often you would like to reorder. Then just say no to those items you don't need (not discolored, ripped, torn, whatever). I hear you though. I wanted to get my supplies every 3 months and that keeps stopping my order. It's maddening because it's ANOTHER thing I have to track (as a caregiver, you get to really hate dealing with this Medicare stuff no matter what it is).
Example: My brother had a water chamber that worked perfectly fine for 2 years. They busted it at the hospital. Brought in replacement. They then busted it at the nursing home. Fortunately, I had a SECOND backup. So, I go with two backups for everything because you just never know when that is needed. His unit would have been UNUSABLE for him without those extra water chambers. Some can do without the humidity - he can't.
As to fraud, it is not fraud to have sufficient supplies for the durable medical device to continue to work without interruption. If this bothers your, then buy some supplies online as a backup to use during that time between when your Medicare paid-for supply fails and you get a new one from the DME.
RE: medicare questions?
OK I'm going on my soapbox. First you pay into Medicare your whole life. Your entitled to those supplies you've been paying for them already not the Government.
Second the DME has no right to be asking you if the parts are worn out. They are required to supply you and are just trying to scam you out of those supplies.
Last is that the DME's don't make much profit if any off the supplies so they don't like to send them. But don't feel sorry for them because they more than makeup for it off the machines they sell. If you don't want to order due to the co-pay than I understand. But don't feel any guilt if you do order.
RE: medicare questions?
I think "entitlement" is one thing, but it's pretty obvious that some people obtain supplies beyond their needs and sell them to supplement income. Especially individuals that quit using their CPAP but keep getting the supplies are the very definition of fraud. I think it's fine to establish some "need" for the supplies, and I'm sure that is done a number of different ways. It's really not okay to just accumulate or sell surplus stuff due to a sense of entitlement. Most people here seem to get it right.