When and if you are forced to receive medical care in the home setting, chances are that you will need the proper resources to sustain your illness or condition. It is rather difficult to have to deal with the prospect of overcoming a physical hindrance but when you don't have the adequate equipment, it is even more challenging.
With Medicare, which is an insurance program that provides health insurance coverage to people who are 65 and over, you can meet the special criteria to receive the durable medical equipment built specifically for convenient use within the home. At least in the United States, there are four parts to the Medicare social insurance program. Part A, a hospital insurance, covers particular hospital costs such as hospital stays or rehabilitation. Part B is a medical insurance that helps you pay for some services and products not covered in Part A and includes specific services like nursing, vaccinations and blood transfusions. More importantly, Part B also aids you in being able to afford durable medical equipment that can include anything from iron lungs and oxygen tanks to hospital beds and wheel chairs. Expendable and disposable medical equipment and supplies such as bandages and rubber gloves are not considered by Medicare to be durable medical equipment and is therefore not covered.
Because of its universal nature, there are complex rules when it comes to managing the benefits for this insurance program and advisories are often dispensed to explain the precise coverage criteria. In addition to the disposable medical supplies, are also other instances where Medicare does not pay for your durable equipment and it is important that you know these limits. First of all Medicare only covers durable medical equipment when it is proven to be absolutely necessary and "reasonable for the treatment of an illness or injury." In this vein, Medicare does not pay for air conditioners, dehumidifiers and other supplies that are seen as supplemental but not primarily medical in nature.
How much does Medicare pay and how can you get Medicare coverage for your durable medical equipment? They will determine the maximum value of each piece of medical equipment and come up with a rate called the "approved amount". They then pay 80% of this quote. It is important to note that Medicare won't pay for the purchase of a durable medical equipment valued at over $150 all at once. In these special cases, they will make monthly rental payments during the period of medical need. If you ultimately decide that you want your Medicare to cover the durable medical equipment you need, you can file a claim--then have your doctor prescribe the equipment for you and complete the DME Medical Necessity form.
