Pugsy wrote:squid13 wrote:Next time I order from them I'll quiz them about not being able to order a 3 month supply. Maybe who ever I was talking to was screwed up.
StuUnderPressure wrote:Well, I guess I should be getting an advanced fitting for my prison stripes.
I just ordered & received by mail from my DME a 6 months supply of both filters & cushions.
I think it is most likely more of an in house interpretation of the allowance schedule and how they want to enforce it.
My DME goes strictly by the month thing and has been that way since 2009. For nasal pillows I can get 2 per month but that's it and I had to ask about that...they were just giving me one and expect me to come by in 2 weeks. When I asked "can I have 2 and save my gas"...they said "sure" but no more than 2 per month and they eyeball the dates.
I suspect the same for filters but after getting one from them and getting billed for what I could buy 12 of them for online...no more DME filters.
Even with the write off...my co pay was still $5 and change for just one.
Same thing about the generic cheapo gray long hose. My co pay was more than what I could buy it online for.
My DME pushes the 3 month supply because it saves them money.
They mail me everything because they sell primarily Respironics & I am ordering ResMed. I am pretty certain someone else is drop shipping my supplies, but I am happy with the arrangement & don't make noise about it.
They also do less paperwork doing just 1 order instead of 3 orders.
I get all of my ResMed brand (sealed in the bag) filters 3 months at a time.
I get 3 bags of 2 filters each.
But, I have only let them order me a 3 month supply of cushions twice because I don't want to be tied in to 1 particular mask if I later decide to change.
The only time they would NOT let me order a 3 month supply of filters was at the end of 2013. Their theory was since it would soon be a new year, I would have the Medicare deductible to pay & they didn't want to sell me 3 months of filters in November with NO copay when (in their mind) I WOULD have to come up with the Medicare deductible if they sold me those in January.
That does NOT apply in my case since my Secondary BC/BS pays 100% of the Medicare deductible every year AND the 20% that Medicare does not pay.
But, to save the frustration, I let them sell me only a 1 month's supply of filters.
I know that DMEs say that Medicare requires a lot of things.
But, I have yet to find one that can be documented.
NOT saying this is not a real Medicare change, but until I see official documentation, it is not real to me.
By the way, there IS documentation in the Medicare regulations for DME provided supplies that actually allows the 6 month supply for "small items".
I stumbled upon it once while looking to verify something else DMEs were saying. But, since it is not a big thing to me either way, I never printed it nor saved it anywhere. But, it is there.
