Buying supplies, Michigan Medicare prices?

Xan20 · Post by **Xan20** » Fri Mar 20, 2020 12:36 pm

Tried to get prices Medicare allows for ResMed P-10 pillow mask, heated hose, washable water chamber, filters . Spent 90 minutes with four different people, levels, and nobody will give me the information unless I’m “in the system and ordering.”
Copays don’t matter as high deductible. There is one amount allowed from Medicare. Why can’t I find this information to know if cheaper to buy cash online? Thought my responsible to be good consumer?
Does anyone know the Medicare allowed amounts for these items? I think they bill for each part of the mask?

Okie bipap · Post by **Okie bipap** » Fri Mar 20, 2020 1:32 pm

If you are using Medicare, you only pay 20% of what Medicare pays, not 20% of the sky in the pie price the DME says they are charging. We use full face masks, and the price Medicare paid for our last masks was around 75% of the MSRP. We would have been responsible for 20% of that amount if we didn't have other insurance that covered it.

Pugsy · Post by **Pugsy** » Fri Mar 20, 2020 1:46 pm

Xan20 wrote: ↑
Fri Mar 20, 2020 12:36 pm
Copays don’t matter as high deductible.

If you are using Medicare what high deductible are you talking about?

Medicare allowable pricing varies county by county and sometimes city by city so it's next to impossible for anyone here to tell you what Michigan allowable prices are for anything unless they live in the same city you are living in and using the same equipment you are using.

LSAT · Post by **LSAT** » Fri Mar 20, 2020 1:50 pm

Xan20 wrote: ↑
Fri Mar 20, 2020 12:36 pm
Tried to get prices Medicare allows for ResMed P-10 pillow mask, heated hose, washable water chamber, filters . Spent 90 minutes with four different people, levels, and nobody will give me the information unless I’m “in the system and ordering.”
Copays don’t matter as high deductible. There is one amount allowed from Medicare. Why can’t I find this information to know if cheaper to buy cash online? Thought my responsible to be good consumer?
Does anyone know the Medicare allowed amounts for these items? I think they bill for each part of the mask?

It will not be cheaper to buy on line if you are using Medicare..assuming you have a Medicare suppliment or a Medicare Advantage plan. You only pay 20% of the Medicare NEGOTIATED prices. A heated hose should cost you about $6...a standard hose about $3....Water chamber...about $4.

chunkyfrog · Post by **chunkyfrog** » Fri Mar 20, 2020 2:28 pm

I just received a new p10 mask from my DME.
The statement lists all parts separately.
"Application device"--$164.66 retail vs $56.29 allowed
Pillows--6/$238.50 retail vs $93.06 allowed
Using Medicare, your payment would be 20% of the allowed figure.
Headgear--(not on statement, my DME [[ACS]] kicked it in this time)
Does this help?
Edit: as to deductible, mine was understood to be $185 this year,
but between diabetes testing supplies, dr appointments, and physical therapy,
I have not yet gotten a bill--but I know what to expect if I do.

Buying supplies, Michigan Medicare prices?

Buying supplies, Michigan Medicare prices?

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Re: Buying supplies, Michigan Medicare prices?

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