Curious how long ago this was? It seems like in the last year or two Kaiser changed to perpetual rental forever. And Medicare has not done outright purchases for DME for as long as I've been aware of their policies. Kaiser Senior Advantage follows Medicare guidelines. However, some people may have Kaiser through an Employer Group Health Plan if they are either still employed OR coverage in retirement is an employee perk.I was also given the option of buying or renting for 13 months. Not knowing how well it would work for me I chose to rent. I went home with the Airsense 10 Auto, heated hose, N20 mask and headgear and two filters all in a case. After less than 2 weeks I was sold. I emailed Kaiser and changed from rent to purchase. Note: the sum of the rental payments equaled the purchase cost. This was done and in due course I received a bill from Apria for the equipment purchase cost plus 1 months rental.
Here is the 2021 "Evidence of Coverage" which is the actual contract between Kaiser and a Senior Advantage member that most people never see unless they know to ask for it: https://healthy.kaiserpermanente.org/co ... eds-ga.pdf
And here is what it says:
(Emphasis added) In other words. You make copayments in perpetuity.In Original Medicare, people who rent certain types of DME own the equipment after paying
copayments for the item for 13 months. As a member of our plan, however, you will not acquire
ownership of rented DME items no matter how many copayments you make for the item while a member of
our plan. Even if you made up to 12 consecutive payments for the DME item under Original Medicare
before you joined our plan, you will not acquire ownership no matter how
many copayments you make for the item while a member of our plan.
This is for Georgia, because that's what showed up first in Google.
But the same for Northern California https://healthy.kaiserpermanente.org/co ... e-ncal.pdf (pg 52) and I suspect most if not all of the other regions.
Sleep Geek says
Be sure to read this before you contemplate dropping supplemental coverage altogether if you want to dump Kaiser. https://www.medicareresources.org/medic ... ge-enough/ With no out-of-pocket maximum, you have to decide how much risk you are willing to take.To OP:
IF you go on traditional Medicare do you need MediGap?
Remember Open Enrollment is coming only a few weeks away.
Think of it this way - you will kill two birds at once and hit a HomeRun!
You can pick up a co-pay to pay the 20% if you want but traditional Medicare you won't need referrals.
Every state has a SHIP program (but in California it's called HICAP). It's listed on the very back outside cover of your "Medicare and You" booklet or you can find your state's number on www.medicare.gov. This is FREE counseling about Medicare and they are federally funded, not funded by the insurance industry. They can help you determine the best option for your personal situation and calculate your out of pocket costs for various options.
SleepGeek also said
Since I am no longer on Kaiser's DME plan, I don't know if this has changed, but when I was, Kaiser had it's own formulary for masks with Crapria. I'm sure that's part of their Crapria contract to keep costs low. So the result was that Kaiser prescriptions had to specify exactly which mask, and you couldn't change to another one without a prescription for the specific mask. Some of the newer masks took a while to appear on their formulary, and masks like the SleepWeaver were NEVER on their formulary.Make sure for the mask it says "Mask of Patients Choice"