Course on Medicare DME coverage

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
Janknitz
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Course on Medicare DME coverage

Post by Janknitz » Sun Dec 10, 2017 9:14 pm

I have not taken this course myself but I thought it might be of interest to some: https://www.medicareinteractive.org/cou ... ipment-dme

It costs $10. Course description is as follows:
This course provides important information on Medicare coverage of Durable Medical Equipment, or DME. In this course, you will become familiar with the definition of DME, according to Medicare rules. You will also learn Medicare coverage requirements that individuals must follow in order for Medicare to pay for DME they need. Additionally, you will learn about coverage rules for renting, buying, fixing, and replacing DME. Finally, the course will introduce you to the differences between Original Medicare and Medicare Advantage coverage of DME.
NOTE: It is not specific to CPAP so I can't say how useful or not it may be.
What you need to know before you meet your DME http://tinyurl.com/2arffqx
Taming the Mirage Quattro http://tinyurl.com/2ft3lh8
Swift FX Fitting Guide http://tinyurl.com/22ur9ts
Don't Pay that Upcharge! http://tinyurl.com/2ck48rm

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greatunclebill
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Re: Course on Medicare DME coverage

Post by greatunclebill » Sun Dec 10, 2017 11:58 pm

between the medicare handbook, the medicare web site and this forum people can get all their questions answered pretty easy without spending $10.

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LSAT
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Re: Course on Medicare DME coverage

Post by LSAT » Mon Dec 11, 2017 5:36 am


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chunkyfrog
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Re: Course on Medicare DME coverage

Post by chunkyfrog » Tue Dec 12, 2017 11:10 pm

Hmmm, this sounds like something that should be offered for FREE by SHIIP.

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SewTired
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Re: Course on Medicare DME coverage

Post by SewTired » Wed Dec 13, 2017 4:02 pm

It's geared towards professionals in the medical field, not recipients.

The big thing to find out before getting a DME item is what are the rules? For instance, if you were getting a walker through Medicare, did you know that you won't qualify for a wheelchair for 5 years? You'd have to pay for it out of pocket. So, unless you KNOW you likely won't need that wheelchair, get that walker at Walmart for $120 because good quality wheelchairs are $500-900 depending on your size and needs (and electric wheelchairs are $1,500-4,000). If you do get a DME item, be sure to have some reminder somewhere to get all repairs before that 5 years is up. My brother just missed getting the wheels replaced on his Cadillac walker by 2 months. Now he has to pay $60 to get just 2 of them replaced. I didn't even know there was a 5 year warranty by Medicare or I could have brought it in any time in the prior year.

For CPAP bought through Medicare, repairs are covered for 5 years, but they do not cover the repairs if you dropped it on the floor. So, if you DID drop it on the floor, just say it stopped working (yes, brother opened his mouth and got socked with $800 repair on his first bipap). Water damage may or may not be covered, I'm unsure on that. Replacements of cpap after 5 years seems to vary by DME due to the new requirements according to posts here. However, if your machine is at least 15,000 hours run time, then it qualifies for replacement.

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greatunclebill
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Re: Course on Medicare DME coverage

Post by greatunclebill » Wed Dec 13, 2017 9:17 pm

walkers are under $50. i got one for $5 at a yard sale, 2 wheels and 2 tennis balls. the bigger ones with brakes and wheels are rollators or rollator walkers. rollators can be bought $50 - $100 or more. when you get the rollators with seat and basket, medicare doesn't pay for the seat or basket. those are extra out of pocket. it's best to watch yard sales and thrift stores for these. when people die and don't need them, that's where they usually go. I even ran across a dme that sells them used on consignment.

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Mask: Quattro™ FX Full Face CPAP Mask with Headgear
Additional Comments: myAir, OSCAR. cms-50D+. airsense 10 auto & (2009) remstar plus m series backups
First diagnosed 1990
please don't ask me to try nasal. i'm a full face person.
the avatar is Rocco, my Lhasa Apso. Number one "Bama fan. 18 championships and counting.
Life member VFW Post 4328 Alabama
MSgt USAF (E-7) medic Retired 1968-1990

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Okie bipap
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Re: Course on Medicare DME coverage

Post by Okie bipap » Thu Dec 14, 2017 10:00 am

Both orthopedic surgeons that have worked on me told me to never get one of the pollinators because they can be unstable and roll out from under you if you get a little off balanced or trip.

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SewTired
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Re: Course on Medicare DME coverage

Post by SewTired » Thu Dec 14, 2017 11:45 am

greatunclebill wrote:walkers are under $50. i got one for $5 at a yard sale, 2 wheels and 2 tennis balls. the bigger ones with brakes and wheels are rollators or rollator walkers. rollators can be bought $50 - $100 or more. when you get the rollators with seat and basket, medicare doesn't pay for the seat or basket. those are extra out of pocket. it's best to watch yard sales and thrift stores for these. when people die and don't need them, that's where they usually go. I even ran across a dme that sells them used on consignment.
That's great greatunclebill. I always recommend getting used first - if nothing else, it provides you a backup so you can have one in the car and one in your home. However, those run of the mill walkers and rollators are designed for folks weighing less than 225 lbs. and 5'11 and shorter. If you weigh more than that or are taller than that, the price goes up substantially because they have to use different materials or extensions. Bariatric rollator is considerably heavier as well. My brother's rollator is about $450 (and yes, Medicare paid for the seat). You can get a similar, lesser brand through Walmart for $150-200.

Yep, we used Craigslist to get all sorts of medical equipment needed temporarily. You just have to be careful as walker wheels are often worn out and this is what helps stabilize you.

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SewTired
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Re: Course on Medicare DME coverage

Post by SewTired » Thu Dec 14, 2017 11:48 am

Okie bipap wrote:Both orthopedic surgeons that have worked on me told me to never get one of the pollinators because they can be unstable and roll out from under you if you get a little off balanced or trip.
Absolutely great advice depending on what your particular issues are. They told me at the hospital the same thing because I am unstable in the first place due to a permanent leg injury. So, when needed, I have a regular walker. My brother, on the other hand, is bent over from spinal damage (arthritis), so his need is more appropriate for a rollator. He also doesn't use it to get out of a chair (where instability is the worst) and uses canes instead.

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Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear
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Airsense For Her; Settings: range 8-12, Airfit P10 (M)