After you meet the Part B deductible you pay 20% of the Medicare-approved amount (if your supplier accepts assignment). Medicare pays for different kinds of DME in different ways. Depending on the type of equipment:
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Make sure your doctors and DME suppliers are enrolled in Medicare. It&#;s also important to ask a supplier if they participate in Medicare before you get DME. If suppliers are participating in Medicare, they must accept assignment (which means, they can charge you only the coinsurance and Part B deductible for the Medicare&#;approved amount). If suppliers aren&#;t participating and don&#;t accept assignment, you may have to pay for the full cost of the DME.
We may use a few terms in this article that can be helpful to understand when selecting the best insurance plan:
There are times when a doctor may feel it is medically necessary for a person to use a hospital bed at home. If this is the case, then Medicare will help cover the cost of this durable medical equipment (DME).
When a doctor deems it medically necessary, Medicare will cover hospital beds to use at home. Generally, Part B will cover 80% of the cost. Medigap and Medicare Advantage may pay more.
Typically people will rent DME, but sometimes they can buy the equipment. Individuals may be able to choose whether they would like to rent or buy a hospital bed.
Items are considered DME when they meet the following criteria:
Medicare provides coverage for certain types of durable medical equipment (DME), such as hospital beds, when a doctor prescribes its use.
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Under Original Medicare, Part B will cover hospital beds for use at home.
It is important that both the prescribing doctor and the supplier of the hospital bed are enrolled in Medicare. A person should always check that the supplier is part of Medicare before getting any kind of DME from them.
In order for Medicare Part B to cover a hospital bed, the prescribing doctor must not only provide a prescription but other detailed paperwork as well. They must also provide detailed information on the individual&#;s medical condition and establish the need for a hospital bed. The order must include:
Medigap, or supplement insurance, may also help pay for the costs of a hospital bed.
Medicare Advantage (Part C) plans must provide the same coverage as Original Medicare. This means they will generally cover the use of hospital beds at home. A person can speak with their provider for more information.
Learn more about Medicare Part B.
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