What is Covered by Medicare
Author: Steve Wynler
Published: 2009-03-12 : (Rev. 2019-02-08)
Synopsis and Key Points:
Medicare offers several categories of benefits Part B of Medicare covers visits to doctors offices and durable home medical equipment.
In 2007 over 40 million United States citizens used some form of Medicare to help them pay for their medical treatment.
Medicare is a form of heath insurance, created by the federal government, to help those that are disabled or over the age of 65. It offers several different categories of benefits. Part B of Medicare covers visits to doctor's offices and durable home medical equipment.
Durable medical equipment refers to medical equipment that can be re-used and does not have to be discarded. Things such as walkers, crutches, and wheelchairs are examples of durable medical equipment. In order to receive compensation for this type of home medical equipment, it must be deemed medically necessary. This typically involves only a prescription from a doctor, but for certain types of equipment it is necessary to have your doctor fill out a Certificate of Medical Necessity. This is a very simple form that in essence is just a more detailed prescription. Some items that require this form are oxygen equipment and supplies, patient lifts, and bone growth simulators.
After the patient has met the yearly deductible, $135 in 2008, they are eligible to have their medical equipment covered. There are many different types of durable medical equipment that is covered by Medicare and generally they will cover 80% of the cost. The patient is then responsible for the remaining 20%.
Medicare also covers the rental of durable medical equipment.
For some smaller items Medicare will only pay the cost of the item in rental fees, so it may be a good idea to go ahead and purchase these types of items. For other larger items like hospital beds or oxygen equipment, Medicare will pay rental fees for a certain amount of time, 13 months and 36 months respectively, after which time you will own the device. They will continue to maintain the devices for you in cases where you rented to own. Many times Medicare will also cover 80% of the repair cost of your equipment.
Power wheelchairs and mobility scooters are one type of durable medical equipment that is covered by Medicare. In order to have Medicare cover the costs of these devices, it is necessary to have a doctor's prescription. The device must also be for use in the home. If the device is only needed for use outside of the home, then it will not be covered.
Another type of device that is partially covered by Medicare is the lift chair.
This falls into the category of a patient lift, so it will require your doctor to fill out a Certificate of Medical Necessity. In addition it is necessary for the lift to allow the person to stand completely on their own without outside assistance. The only part of the lift chair that is covered by Medicare is the actual lift mechanism, which usually amounts to at most $300.
A large amount of other products are also covered.
This includes things like prosthetics, pneumatic compression devices, and under certain situations glasses. Typically if you have Medicare and are covered by Part B benefits, you can purchase the item and then submit the receipt, a doctor's prescription, and a Certificate of Medical Necessity to Medicare. They will then mail you a check.
For a complete list of what is covered, check out the medicare website.
- 1 - Key Drivers of Health Care Costs : American College of Physicians (2009/09/09)
- 2 - Lower Out of Pocket Insulin Costs for U.S. Medicare Seniors : Centers for Medicare & Medicaid Services (2020/05/26)
- 3 - Medicare and Medicaid Services Not to Go Forward With Part B Payment Proposal : American College of Rheumatology (2016/12/17)
- 4 - U.S. Medicare and Telehealth Services During COVID-19 Pandemic : Disabled World (2020/03/22)
- 5 - Center for Medicare and Medicaid Innovation Must Implement Payment Reforms Rapidly : Commonwealth Fund (2010/06/08)
- 6 - What is Covered by Medicare : Steve Wynler (2009/03/12)
- 7 - Medicare Recipients Can Be Denied Supplemental Medigap Coverage Due to Pre-Existing Conditions : The Senior Citizens League (2018/11/15)
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