Perspective               

Consumers Know Little About Durable Medical Equipment Rules

Wheelchairs, scooters, walkers, glucose monitors, and prosthetic limbs-these are just a few examples of durable medical equipment that Medicare covers. If you use durable medical equipment, there is important information that you may not know about getting and paying for it. For instance, do you know the difference between Medicare-certified and Medicare-participating medical equipment suppliers? A participating supplier always "accepts assignment" and therefore can only charge you 20 percent of the Medicare-approved amount for any medical item. A certified supplier, on the other hand, does not always "accept assignment" and can charge you much more.

Studies show that many people have problems understanding these differences among suppliers as well as rules for Medicare coverage of medical equipment and supplies. A recent report released by the Department of Health and Human Services Office of the Inspector General showed that not even half of people with Medicare surveyed knew the differences between paying for assigned claims, which limit their costs, and non-assigned claims, which can cost people a lot more. Only four out of ten people surveyed knew that if they choose a participating supplier or a supplier that always accepts assignment on a particular item, they pay only 20 percent coinsurance. At the end of the telephone surveys, some people with Medicare remarked that they had never even thought about the potential to save money by buying equipment from a Medicare-participating supplier or a supplier that accepts assignment on a particular item.

To save money, you should always use Medicare providers who take assignment. If you do not understand your Medicare medical equipment benefits, rights, and options, call 1-800-MEDICARE and ask for a free pamphlet called "Medicare and Home Medical Equipment." It is also available on Medicare's Web site at www.medicare.gov. The pamphlet teaches you how to get home medical equipment, recognize a good supplier, and protect yourself against fraudulent suppliers.

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