It is safe to assume that as the population ages, they will need home medical equipment and supplies. But these supplies are not only for the elderly. Illness, disease, injuries and disabilities have no age limit.
Should your love one require home medical equipment, finding out what the insurance covers will help to reduce your costs.
Medicare
Medicare is the countrywide health insurance program for those over 65 years of age. Some people under age 65 might be covered depending on the Medicare qualifying disability or disease.
Medicare covers different kinds of medical equipment and supplies with the proper documentation such as a prescription from a doctor or a Certificate of Medical Necessity.
Medicare Part A covers those in hospital, home health care or nursing home. If not Medicare Part B may cover medical equipment and supplies.
Medicare will cover the following medical supplies and equipment:
- Certain catheters
- Ostonomy supplies and bags , irrigation , flushing equipment , and supplies
- Items necessary for feeding tubes ( like catheters , filters , and nutrient solutions )
- Materials for tracheotomy treatment
- Dressing necessary for treatment of an injury as a result of surgery or after debridement ( eliminating non-living tissue of an injury)
- Diabetic products, glucose meters and Diabetic Footwear
- Respiratory equipment such as home oxygen apparatus & devices for sleep apnea
- Manual or electric wheelchairs, and motorized scooters
Additional supplies and equipment might be included once they can be proven to be medically required and your physician has recorded it in your medical history.
Some medical equipment is considered “personal convenience” and are not covered by Medicare. Here are some items not covered:
- Raised toilet seat
- Shower/commode wheelchair
- Grab bars and other safety equipment for the bathroom
- Hearing aids
- Incontinence supplies such as briefs and under pads
Find out ahead of time how much Medicare will cover and make sure you correctly complete all the necessary paper work.
Medicaid
This is a state run insurance program and it varies from state to state. You will most likely need approval ahead of time from Medicaid before placing an order for medical supplies and equipment. Your doctor will also have to provide written explanation of:
- Your medical diagnosis and prognosis
- How the tools / equipment will help recuperation and/or everyday life functions
- Anticipated effects of no equipment/supplies or not employing the suggested equipment/supplies
- When substituting less costly devices are unsatisfactory, explain why
- Amount of time the equipment is required
- You have been or are going to be trained in the use of the devices correctly and that you can do it