Posts filed under 'Medicare Categories'
Durable equipment, such as wheelchairs, walkers, hospital beds and other medical equipment has long been the subject of frustration because of their costs. If an individual has Medicare, often Medicare pays for some or all of these items, with little cost to the recipient.
However, the costs of much of this equipment are extremely high, and not affordable to most Medicare recipients. Even though Medicare helps with the expenses, there are still issues that are being addressed.
Medicare has determined that the costs are too high for them, as well. They have proposed a solution that would help consumers and help the Medicare program itself. To save money for recipients and the Medicare system, Medicare wants to institute a competitive bidding process for some durable medical equipment. This would mean that companies that supply these items would have to bid toward the lowest price in order to be given contracts through Medicare. In addition, these lower price savings would be passed on to Medicare Beneficiaries.
On the surface this seems like a good idea, and in many cases, it would work. The problem is that many of the companies that provide this equipment are small businesses that have a small profit margin. Some of these businesses have no room to decrease their prices and as a result, might be shut out of the process of providing durable equipment through Medicare. This could severely cripple the businesses or even put them out of business.
Another drawback is that there would probably be fewer choices for Medicare recipients along with fewer knowledgeable providers. Patients might have to switch from their current providers to a new one that they don’t know. Some beneficiaries have been affected already, as the bidding process has started. It is taking longer to get their equipment. A high percentage of providers have already had to cut back or go out of business.
In the long run, things will even out. In the short term, however, if you are a Medicare recipient, try to deal with durable equipment in advance. Put your order in early, and try to be patient as everything is sorted out. We can all be hopeful that the discounts will truly be passed on, saving beneficiaries money on essential equipment they need.
During the past decade or more, there has been a push by citizens, advocates and, yes, even congress, to allow individuals to have home health care rather than staying in a facility. As many of us know, a person that can live at home and interact in the community, while being taken care of medically, will most likely live a longer and fuller life.
One state, Connecticut, has moved into the cadre of states who are working to allow individuals to stay at home, get home health care, and live full lives. Senators there have passed a bill that will move about 5,000 individuals who are elderly or disabled out of care facilities and institutions back to their homes and their communities.
This is vitally important. Statistics have shown that individuals that have community support and independent living, live longer and are healthier than those who are confined to hospitals, institutions and long-term care facilities. This does not mean that everyone is capable of living on their own and interacting in the community without assistance. Some individuals might be better in a variety of care settings. However, it has long been known that there are many individuals in facilities, hospitals and institutions that should really be able to live in the community.
This is a win-win situation. Medicaid will save money – it is much less costly to live in a group home or apartment and have a variety of supports defraying the costs, than it is to stay in a hospital, facility or institution where rates range (depending on the area the person lives in) from nearly $200 per day to over $1,000 per day.
I have personally worked in several states with individuals who were involved in independent living programs. Some lived in group homes and others lived in their own apartment. Still others were able to live at home with their families. Many of them had gainful employment, meaning that in many cases, they either needed less benefits and actually paid taxes, helping the economy; or they had small jobs that prepared them to move forward in the community and eventually be self-sufficient.
No matter what the situation, helping individuals that are able to integrate into the community and work toward independence is a huge step forward for the individual, the community they live in, and society in general.
At this time, it looks as though the trend has caught on and is continuing. In the long run, it can save Medicaid and communities millions of dollars. In the short term and the long run, it will heal individuals, families, and the community and make all of these entities stronger and richer for the progressive change.
When you become eligible for Medicare at age 65 or because of a disability, you will automatically receive original Medicare benefits.
Something you may not realize is that depending upon the state you live in, you may be entitled to two other choices. These choices provide more coverage for issues that original, basic Medicare does not cover.
One choice is Original Medicare with supplemental insurance, such as a Medigap or retiree plan. The other choice is a Medicare Private Health Plan, also known as a Medicare Advantage Plan, such as a Health maintenance Organization (HMO), a Preferred Provider Organization (PPO), a Point of Service Plan (POS), a Provider Sponsored Organization (PSO), a Private Fee For Service Plan (PFFS), a Special Needs Plan (SNP) or a Medicare Medical Savings Account (MSA).
All of these plans provide various forms of coverage that is different than original Medicare. In addition to these plans, Medicare Part D is available to cover prescription drugs. If you are covered by original Medicare, it is important that you find additional coverage that will work well with your coverage. Often, a stand-alone prescription plan that only covers drugs (PDP) is the best choice.
A Medicare private health plan can be obtained to fulfill the health plan’s benefit package that covers drugs. If you join a PFFS without drug coverage or an MSA, you can get stand-alone drug coverage.
Regardless of which type of plan you decide on and depending upon what is available to you where you live, it is essential that you research available plans and coverage and decide what will be the best for your situation.
As a person who is diabetic, you know that you need special devices in order for you to properly monitor your blood glucose levels. This is essential in managing the diabetes disease effectively and helps you live a more normal and fulfilling life as well as preventing complications that is associated with diabetes.
If you have Medicare, you will want to know about the coverage it provides for diabetics. Basically, you will see that the Medicare Part B will be able to cover different kinds of equipments that is specially designed for use for diabetics.
Part of the coverage is the blood glucose monitors, which will test the amount of glucose in your blood; test strips, which you will use to put a sample of your blood in to test in the blood glucose monitor; and it will also include lancets that you will use to puncture your skin in order to draw the blood sample to be tested.
If you have Medicare and is a diabetic, then you will be able to take advantage of this benefit. Even if you are a non-insulin or insulin user, you will still qualify for the coverage that Medicare provides for diabetics.
In order to get your supplies, you need to get a prescription from your doctor. The prescription should state that you have been diagnosed with the disease, the amount of test strips and lancets you need every month, and what kind of glucose meter you need. You will see that there is a special meter designed for people who have vision problems. Also, the prescription should state whether you are an insulin user or not and the frequency on how you test your blood sugar.
These are the things that are covered under Medicare for diabetes. So, if you have this disease and you are covered by Medicare, you can be sure that you will be able to properly manage it with the help of Medicare by providing you with blood glucose monitoring equipments.
If you are having problems with mobility then you will most liekly need an electric wheelchair to do your daily activities. However, you have to consider the fact that not all people can afford such equipments.
If you have Medicaid, then you will see that this healthcare program provided by the state and federal government of the United States will be able to help you out in terms of financing the purchase of the equipment.
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If you’re having mobility problems you might qualify for an electric wheelchair under Medicare coverage. An electric wheelchair solution can greatly improve the quality of life for mobility impaired patients and is well worth considering as an available option. The new Electric wheelchair provisions from May 2005, allow for partial or complete coverage of an electric wheelchair, based on the need of the patients.
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Hoveround electric wheelchairs are popular mobility solution for people having trouble getting around as much as they’d like to; and with your doctor’s help these mobility solutions are almost completely, or is some cases 100%, covered. These electric wheelchairs can greatly improve the quality of life of someone who, because of pain or disability, cannot get out of the house as much as they’d like.
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The Scooter Store, the nation’s largest supplier of power wheelchairs (electric wheelchairs) and mobility scooters, today announced it supports changes to the Social Security
Act that would eliminate language restricting power wheelchairs and
scooters obtained through Medicare to use inside a person’s house or home.
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The Scooter Store is the nation’s largest provider of powered mobility, which includes electric wheelchairs and scooters. Founded by Doug Harrison, the company has recently battled Medicare over allegations that it committed fraud or abused the Medicare system.
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Most medical equipment supply companies offer a vast line of electric wheelchairs. The different versions will vary by size, weight capacity and other options. There are oversized chairs for bariatric (or obese) patients. There are smaller chairs for children and petite adults. There are also different seats, colors and footpads for chairs.
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Once your doctor has completed all of the necessary paperwork for an electric wheelchair and the medical equipment supply company has agreed that you are a qualifying candidate, it’s time to work out any financial obligations. The medical equipment supply company you work with will submit your claim to Medicare for reimbursement.
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In October of 2005, Medicare began requiring any patient seeking an electric wheelchair or mobility scooter to have a face-to-face exam with a physician. This exam serves as an evaluation to ensure that the patient meets all of Medicare’s requirements for power mobility including electric wheelchairs and scooters. Most of the time, the patient has already met with a medical equipment supply company who will send over paperwork to the physician to be completed during the exam.
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Once a person has met the initial eligibility guidelines for an electric wheelchair, it’s time to visit a medical equipment company to initiate the Medicare process and paperwork. There are many companies out there that can assist you in getting an electric wheelchair. There are large companies like The Scooter Store and Hoveround and there are thousands of small independent medical equipment suppliers throughout the country.
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The Centers for Medicare/Medicaid Services (Medicaid) today announced that it has bumped the reimbursement rate for power mobility devices (power wheelchairs and scooters). CMS increased payments for the K0823 class of chairs/scooters by $75.20 and and the K0825 class by $277.60.
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