Durable Medical Equipment (DME) is equipment that is meant to serve a medically therapeutic purpose and made to last a "lifetime" length of five years.
All insurance companies require documented medical necessity from a doctor or a licensed medical professional. Talk to your care provider and see if they agree that the item you want will be beneficial for you. If you or the provider have any questions, a member of our team will always be glad to help.
A trained member of our team can help verify your eligibility and whether there are any co-pays for the item you need. Please feel free to fax, e-mail or snail mail your prescription and insurance information to us and we will gladly provide you with the information you need.
In order for an item to be covered by insurance, it has to be assigned a billable code (This is called a "HCPCS" code). Certain manufacturers get their items approved by the Center of Medicare Services due to their therapeutic use and durability to be categorized as durable medical equipment (DME). While the item you saw on TV might be lighter, more attractive and seem more beneficial, most of them are not coded and will not be covered. Please contact us and see whether or not the item you want could be covered or what the alternative item might be.
With certain insurances, we can charge customers "upgrade" costs for certain items that may be partially covered by their insurance. This can occur when insurance deems certain items on a medically necessary item to be a "convenience" item. For example, Medicare covers a walker and a seat attachment, but views brakes as a convenience item. In order to get a walker with brakes, a customer can be offered to pay an upgrade out of pocket.
As a Medicare Part B beneficiary, some co-pays may occur. At the start of each calendar year, all Medicare beneficiaries have a deductible that must be met before the services are covered. In addition, Medicare covers 80% of all covered services. The remaining 20% must be covered by a secondary payer, which could be a secondary or supplemental insurance, a representative payee or the beneficiary themselves.
If you got your item from our company, we can help you! Depending on how long ago you received the item, and what repair is needed, we can verify what cost, if any, will be required. For routine maintenance such as alignments or tightening of parts, there is a starting fee of $50. For all other repair services, there is a process that must be followed. Please contact us via phone or e-mail pictures to us so that we can start damage assessment and more easily verify if insurance or manufacturer warranty might cover the issue. If you would like one of our technicians to come and assess the item, there is an option to pay a $50 fee. Depending on the assessment and the repair required, we will work the item's original manufacturer to get that part repaired or replaced. Please take not that repairs are a timely process so please be patient as we work to get your equipment up and running while minimizing cost to you.