Going to War with DME again This Morning

[Cereal Killer]

An example from the forum today: DME bills $34.75 and accepts payment of $5.50 which is the price in the insurance company contract.

I really don't understand the purpose of the ridiculously high "retail" prices charged by DME's for supplies. I can't see why anyone would ever actually pay them. I recently had to order filters for my ResMed S9. My insurance covers my supplies at 90% after my deductible is met. I knew I had not yet met my deductible for 2013, so I would be paying the total out of pocket. When I called the DME they quoted me a "retail" charge of $34.70 for a pack of two filters. I knew that I would only actually end up having to pay the discounted price negotiated by the insurance company with the DME. (The DME is "in network" for my insurance company.)

I asked the DME how much that would be, but they said they could not tell me until after the claim was filed. I thought about just ordering them online (pack of 6 for under $12.00). However I wanted whatever I did pay to add to my accumulating deductible, so I went ahead and placed the order. I have been watching my claims on the insurance company's web site to see what I needed to pay. It finally came through. The DME billed $34.70. That got knocked down to $5.50. As expected since I had not met my deductible, the entire $5.50 is my responsibility, and that amount was added to my accumulating deductible.

Would anyone actually pay $34.70 for two small, disposable filters? If you don't have insurance to help pay or at least get the heavily discounted insurance company rate, why would you go through the DME at all? The DME had previously quoted me a "retail" price of $360 for a full face mask and headgear, but I knew that price was fiction as well, and when I do need to order one it will be heavily discounted.

Does anyone ever pay the ridiculous "retail" DME prices?

[ems]

I never thought I'd ever say that I'm glad I'm old enough to be on medicare (plus a supplement). I've never paid one penny out of pocket for the sleep study, visits to sleep specialist, machine, supplies, etc., etc.

Now, don't ya all wish you were over 65?

[Cereal Killer]

I never thought I'd ever say that I'm glad I'm old enough to be on medicare (plus a supplement). I've never paid one penny out of pocket for the sleep study, visits to sleep specialist, machine, supplies, etc., etc.

Now, don't ya all wish you were over 65?

How do you feel about your kids and grandkids and people poorer than you having to pay for the national debt you are gleefully running up?

[ems]

I never thought I'd ever say that I'm glad I'm old enough to be on medicare (plus a supplement). I've never paid one penny out of pocket for the sleep study, visits to sleep specialist, machine, supplies, etc., etc.

Now, don't ya all wish you were over 65?

How do you feel about your kids and grandkids and people poorer than you having to pay for the national debt you are gleefully running up?

Such a stupid thing to say that I won't even bother answering it.

I have paid my fair share over the years. Medicare and Social Security are now mine to enjoy.

[Drowsy Dancer]

There seems to be a lot of smoke and mirrors with DME "retail price" versus "contract price" negotiated by insurer: viewtopic.php?f=1&t=82725&p=750278&hili ... nt#p750278

[Cereal Killer]

Such a stupid thing to say that I won't even bother answering it.

I have paid my fair share over the years. Medicare and Social Security are now mine to enjoy.

But you did answer it and your answer shows you are among those citizens who are wrong and totally clueless.

CBO: The average retiree has paid $114,000 into Medicare will use $355,000 lifetime costs.

[Stormynights]

What would you recommend for us over 65 to do? Refuse Medicare commit suicide or keep working?

[ems]

Such a stupid thing to say that I won't even bother answering it.

I have paid my fair share over the years. Medicare and Social Security are now mine to enjoy.

But you did answer it and your answer shows you are among those citizens who are wrong and totally clueless.

CBO: The average retiree has paid $114,000 into Medicare will use $355,000 lifetime costs.

And your point is what exactly?

[chunkyfrog]

And may I again remind everyone to take advantage of the free consultation, courtesy of your state's
department of insurance, (SHIIP, and others) BEFORE you buy your Medicare supplement, advantage plan,
or other bafflements. It can save you a great deal of money, and maybe even your life.

[DannyPh]

Well. I have one more Shot at winning this Battle but I have my Doubts now. The Local Branch Manager won't budge even after a call from the corporate office. So, Now I am waiting on the decision of the Branch Managers Supervisor at the Corporate Office. They said they would call me tomorrow with a decision. I also called my Insurance and made them aware of the things that are going on and they told me that I should have received a New machine and they are going to contact the Local branch ( For all the Good it will do ) but they did tell me that I could return the Machine and they ( Insurance ) would Help me find another DME that is in my Network. So, now it is just a waiting game to see how things turn out. Either way I still have the s9 auto set even if it has a few run Hours on it. My Insurance ( Humana Medicare Advantage ) said they would contact me in three business days with the outcome of their Investigation.

[Cereal Killer]

What would you recommend for us over 65 to do? Refuse Medicare commit suicide or keep working?

What would I recommend?

1. Enroll in Medicare as soon as you are eligible but use the resources as if you were leaving a debt for your grandchildren and people poorer than you. (You are.)

2. Vote against all incumbents and for fiscally responsible public servants who make personal freedom a top priority.

3. Keep working and "paying in" as long as you are productive.

4. Exercise well, eat well, sleep well and stay healthy.

5. Remove the word "suicide" from your mind.

6. Enjoy life.

[Cereal Killer]

The Local Branch Manager won't budge even after a call from the corporate office.

I always have a bit of admiration for employees who buck corporate.

[Stormynights]

What would you recommend for us over 65 to do? Refuse Medicare commit suicide or keep working?

What would I recommend?

1. Enroll in Medicare as soon as you are eligible but use the resources as if you were leaving a debt for your grandchildren and people poorer than you. (You are.)

2. Vote against all incumbents and for fiscally responsible public servants who make personal freedom a top priority.

3. Keep working and "paying in" as long as you are productive.

4. Exercise well, eat well, sleep well and stay healthy.

5. Remove the word "suicide" from your mind.

6. Enjoy life.

Do you mean people that are poorer than me that never worked in their life and just lived off the government?

[grumpycat12]

Don't know about the rest of you, but I don't think this site is the appropriate place for a discussion of the positives and negatives of Medicare in general. Just my opinion...

[ChicagoGranny]

Do you mean people that are poorer than me that never worked in their life and just lived off the government?

People that never work will not be able to pay back any debt.