Understanding Medicare and Your DME: The Difference in Part A and B Medicare

Understanding Medicare and Your DME: The Difference in Part A and B Medicare

So you’ve just turned 65 and those years of working for a living are finally paying off. You are now entitled to Medicare benefits, thanks to the government. So you have your new red, white, and blue Medicare card and need a couple of items. But do you know how to file your claim or if the services and equipment are covered? Stress no more, because Dougherty’s is here to help make the process as painless and streamlined as possible. This is the first segment of our Understanding Medicare you’ll learn the different parts of Medicare and what they cover.

 

Medicare Part A is coverage while in any of the following facilities:

 

• Skilled Nursing

• Assisted Living
• Rehabilitation Facility
• Long-Term Hospital Care
• Hospice
• Home-Health Care Service

 

While under any of these Medicare will cover almost any type of equipment or adaptive aid, but only if deemed medically necessary as prescribed by a physician. Blood pressure monitors, shower chairs, walkers, wheelchairs, bedside commodes, and compression hosiery are just a few of the items covered under Medicare Part A. Under Part A, there is typically no out-of-pocket cost to the patient. There is little done on the patient’s part when it comes to ordering and actually getting the equipment;

that responsibility is typically left to the facility staff or health care provider.

 

Medicare Part B, however, is active only when the patient is independent and not residing in a facility of any type. If a patient transitions from long-term care to independent living at home, then the Medicare will transition from Part A to Part B. Under Part B the list of covered items is drastically shorter, leaving many items such as blood pressure monitors, compression hosiery, and shower chairs completely non-covered. There is also the possibility of more out-of-pocket costs to patients under Medicare Part B.

Durable Medical Equipment (DME) that is covered under Part B includes, but is not limited to:

 

• Canes

• Braces
• Bedside Commodes
• Crutches
• Nebulizers
• Ostomy Supplies

 

Other equipment, such as walkers and wheelchairs, may or may not be covered under Part B, depending if the provider accepts assignment or not. You can learn more about assignment in a later blog.

 

Still not sure the items you need are covered? Don’t hesitate to call your provider and ask. At Dougherty’s, we can only accept those under Medicare Part B. Patients in a long-term care facility or under home health care with Medicare Part A will need to order their equipment and items through their facility or purchase directly without filing with Medicare.

 

I hope you are beginning to understand your Medicare benefits. Check back for more blogs covering the difference in assignment and non-assignment, and how a capped rental works through Dougherty’s.

 

If you have any questions or concerns, email me at hmcmurray@doughertys.com or call Dougherty’s Pharmacy at   214-373-5302 and our staff will be happy to assist.

 

DISCLAIMER: Information obtained from www.medicare.gov This blog is not meant to provide medical advice, but to inform and educate.

TOPICS: Medical Supplies

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