Question about supplies - BCBS-AL and Medicare

[Rexlan]

I purchased my CPAP machine and do not use a DME. I have been submitting monthly claims to BCBS-AL for supplies consistent with the allowable amounts and cost for the past 10 months and have be paid at a 50% rate. My local DME does not carry what I use and want so it is cheaper for me to buy on the Internet.

BCBS-AL stopped paying and or processing my last 3 claims. Then I got a call and they had a lot of questions about the claims, where I was purchasing and from who and especially why I have complained about them not being processed. The man was actually quite friendly (red flag) and we had a good chat.

His bottom line was I MUST purchase from an approved medicare supplier but there are none other than the DME who would need to special order and that isn't going to happen .... they would lose money. He went on and on how this was for my protection so I didn't get inferior product and the usual uninformed BS. Finally he tells me me this is the way the benefits are structured and it is all in the contract. I have done enhanced searches on the 250 pages of the evidence of coverage and benefits summary and can not find this language about supplies.

Can anyone point me to where it says supplies MUST be purchased from suppliers enrolled in Medicare? Either in BCBS or in Medicare.

In the alternate are supplies lumped in with the machines .... but not clearly stated? I am confused.

Thanks for any help

[LSAT]

If this doesn't work..just check amazon and pay out of pocket. I can get anything from my Medicare DME but I only need 1 hose a year and 1 nasal cushion
for my mask. If I had to pay out of pocket it may cost me $50 yr.
https://www.medicare.gov/supplierdirectory/search.html