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Medicare: DME questions
#1
Medicare: DME questions
I have Medicare. I obtained my second CPAP machine after 6 years on my initial machine and the charges are monthly rental for 13 months. I just noticed a previous post stating “Medicare doesn’t require you to go back when you get a new machine and go through the rental thing again”. Is this correct that beyond the first order, there should be a onetime charge? If so are the dollar amounts the same with a single charge versus a 13 month rental charge?  Also,  is it standard practice for DMEs to divide a mask reorder into cushion, mask and headgear components.
Thanks for your input.
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#2
RE: Medicare: DME questions
I didn't have the rental charge or the requirement to check in monthly with the DME on my second machine from Medicare. My insurances paid $100 so I wasn't billed at all. My mask orders are divided into individual charges and not ll the parts are available for replacement at the same time--some monthly, some 3 months and some 6 months.
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#3
RE: Medicare: DME questions
(03-09-2022, 05:15 PM)SideSleeper Wrote: I didn't have the rental charge or the requirement to check in monthly with the DME on my second machine from Medicare.  My insurances paid $100 so I wasn't billed at all. 


Does anyone know if doing a Medicare rental charge for a second CPAP machine is permissible or how I can check the Medicare rules? 
The rental charge for my second machine will total $331.42 . My machine is a  Resmed AirSense 10 Autoset which I assume is the same price range as SideSleeper's Resmed AirSense 10 Autoset for her. I do have a deductible with my Medicare plan. 
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#4
RE: Medicare: DME questions
You can call Medicare at 800 633-4227. I think it's 24/7. And yes, ordered items are billed as separate pieces.
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#5
RE: Medicare: DME questions
In my post, above, I made a type. It should be 100% paid, not $100. Found this too late to edit.
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#6
RE: Medicare: DME questions
What type of Medicare are you on?  Original Medicare, Original Medicare with a supplement, Medicare Advantage, or an employer retiree plan that works with Medicare?  I should be able to help you figure it out.  I'm a Medicare agent.
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#7
RE: Medicare: DME questions
(03-10-2022, 05:49 PM)SideSleeper Wrote: In my post, above, I made a type.  It should be 100% paid, not $100.  Found this too late to edit.
Was your charge for your replacement CPAP machine close to my $331 rental charge?
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#8
RE: Medicare: DME questions
(03-10-2022, 07:56 PM)thistle Wrote: What type of Medicare are you on?  Original Medicare, Original Medicare with a supplement, Medicare Advantage, or an employer retiree plan that works with Medicare?  I should be able to help you figure it out.  I'm a Medicare agent.

Thank you for your offer. I am on Original Medicare Plan G (2022 deductible $233) with a supplement. As I noted in my post someone had posted on apneaboard that “Medicare doesn’t require you to go back when you get a new machine and go through the rental thing again”. I just asked SideSleeper if the dollar amounts are about the same with a single charge versus a 13 month rental charge. 
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#9
RE: Medicare: DME questions
Rgn3, I never see any bills. If I want to know info I go to my Medicare and Tricare4Life accounts online.
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#10
RE: Medicare: DME questions
(03-10-2022, 09:24 PM)Rgn3 Wrote: Thank you for your offer. I am on Original Medicare Plan G (2022 deductible $233) with a supplement. As I noted in my post someone had posted on apneaboard that “Medicare doesn’t require you to go back when you get a new machine and go through the rental thing again”. I just asked SideSleeper if the dollar amounts are about the same with a single charge versus a 13 month rental charge. 

Your supplement should cover 100% of the copays for DME. You will still have to meet the annual deductible. Make sure you gave your supplement card to the supplier. Also make sure they accept Medicare. Aside from your deductible you shouldn't have any out of pocket expense. 

I couldn't find anything about skipping the rental and owning the device immediately on a replacement. Medicare will cover a replacement once every 5 years. Medicare rules are not always easy to find so it could be that you are right and I just didn't find it. 

Hopefully you're able to get your copays all covered though!
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