Share of Cost, Understand Medicare costs and coverage of DME.

Tuesday, Dec. 15th 2015 6:59 AM

Depending on the equipment, you may have to rent or buy your DME. Know that most equipment that costs more than $150 is initially rented. For rentals, Original Medicare pays 80 percent of the cost of a monthly rental fee for needed equipment for 13 months. You are responsible for the remaining 20 percent coinsurance. In the 10th month of rental, suppliers are supposed to notify you of the option to purchase vs. renting; with the exception of oxygen, which can only be rented. If you are buying your DME, have Original Medicare, and use approved suppliers, Medicare covers 80% of the cost, and you or your supplemental insurance are responsible for the remaining 20%.

Note that if you are paying a monthly rental fee for your equipment, your supplier must perform all needed repairs and maintenance requiring the work of a professional—without charging you extra. If you own your equipment, Original Medicare will pay 80% of the Medicare-approved amount for repairs and maintenance, and you will be responsible for the 20% coinsurance. If you have a Medicare Advantage Plan, you may pay a fixed rate or a coinsurance to rent or buy your DME. Call your Medicare Advantage Plan to find out the coverage rules and costs for your specific DME.

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