Medicare timing schedule?

betty303 · Post by **betty303** » Wed Jul 25, 2007 9:53 am

I have been searching the internet with no success...

Does anyone have the Medicare schedule for how often you can purchase additional equipment/supplies - mask, cushions, headgear, machines, etc.?

Thanks.

GaCRT · Post by **GaCRT** » Wed Jul 25, 2007 10:01 am

Masks are every 3 months. Headgear, cushions are every 6 months. Filters are every 6 months for non-disposable and 2 per month for disposable. Tubing is 1 per month and I believe you can get a new machine every 5 years. There are different policies for some though. And medicare has different regions so you might want to check and see what region you live in. Not sure how to do this but maybe someone else does. This is for region c of medicare. hope it helps a little.

ufo13 · Post by **ufo13** » Wed Jul 25, 2007 10:45 am

Betty:

Go to: cpapforseniors.com- Click on "How it Works"- Then click "what Medicare Pays" and it will bring up the exact schedule of what Medicare pays and when!

Hope this helps,

Steve,
ufo13

Slinky · Post by **Slinky** » Wed Jul 25, 2007 11:37 am

Yes, do check it out, because last I knew (2006) whilst Medicare would pay for mask CUSHIONS or PILLOWS every 3 months, they would only pay for mask HEADGEAR every 6 months. (Unlike the online DME suppliers most local suppliers bill the mask separate from the headgear).

My lousy local DME supplier only allows purchase of a new mask every six months. It seems once they've sold you one mask, the mask and headgear become one piece (altho they still bill Medicare separately for mask and headgear). Go figure. They also do NOT carry the "parts", i.e. if you rip your cushion, you are S.O.L. if it is less than 6 months old 'cause on accountta you aren't going to get just a cushion out of them, you're gonna self pay at their horrendous prices for an entire new mask and headgear.

My 02 supplier, on the other hand, from whom I now get my mask and supplies, other than the continuing Medicare capped rental on the Resmed S8 Elite itself, will provide a full mask AND headgear every 3 months. Now that I've found a mask that is comfortable and doesn't leak I told them there is no need to send me a mask every 3 months, I'll let them know when I need another. But they insist that whenever I need or want one I "am" eligible every three months. I haven't seen yet how they bill it. I assume they just bill the mask at the cushion HCPCS code and rate. I'll find out when my first Medicare statement comes thru w/the new mask on it.

Snoredog · Post by **Snoredog** » Wed Jul 25, 2007 2:53 pm

Here ya go for the latest, you will probably have to unzip it:

http://www.cms.hhs.gov/DMEPOSFeeSched/L ... listpage=4

Slinky · Post by **Slinky** » Wed Jul 25, 2007 3:20 pm

Also, since you are on Medicare, have you gone to mymedicare.gov and registered? You really should. You can find the info you want there plus see a copy of all your allowed and paid Medicare claims, etc.

Medicare timing schedule?

Medicare timing schedule?

Medicare Info!