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Wiki conflict on Medicare/CPAP ownership - cps22 - 12-16-2023
In one page of the Wiki, it says: "Medicare usually pays rent to the DME for 13 months, and after that time, you own the machine." This has been my understanding.
But on a different page of the Wiki, it says:
I have Medicare Part B coverage and the home care company that delivered my CPAP has sent me a letter asking if I want to purchase the unit. I have been on the CPAP device for about 11 months. Why are they asking me that now? What are my options?
Medicare requires the medical equipment provider to send you a letter advising you of your right to purchase the medical equipment. You have the choice to continue renting or to purchase the device at that point in time. If you opt to purchase the device, you will be responsible for a copay. If you choose to continue renting the equipment, the rental agreement will continue for a few more months and no copay is required from you. At the end of the rental time frame, the equipment will remain the property of the DME dealer, you will keep the device and all payments and copays stop.
So which is it? At the end of the rental period, does the DME own it or do you own it? Or do you only own it if you purchase it prior to the end of the rental period? If the DME "owns" it but you keep it, then does that imply they can take it back from you if they want to, such as if they determine you aren't using it enough?
RE: Wiki conflict on Medicare/CPAP ownership - Nightynite - 12-16-2023
You own it at 13 months. My DME sent me a letter at 13 months stating so.
When I first started , I received a used machine. That made me a little mad. I called my DME and they said since it was a rental they were allowed to do that. But I said, well since I’m going to be the owner at 13 months I should get a new one. They said sorry.
So at 12 months I called up my DME again and told them my machine is making a loud noise and I need a replacement. So I was able to turn in my old machine and received a brand new one.
This was way before Covid and someone told me they no longer give out used machines for rentals
but I don’t know if that is still the policy now. So my suggestion to all new cpap folks that get these machines through Medicare . Check your hours on your machine the day you get them.
RE: Wiki conflict on Medicare/CPAP ownership - Sleeprider - 12-16-2023
A 13 month rental is typical for Medicare, and at the end of that rental period, the machine ownership is transferred to the patient, and the DME remains responsible for warranty claims up to 3-years. You should inquire why you got the letter, or call the Medicare ombudsaman who can clarify the coverage requirement and how ownership of the CPAP is handled at the end of the lease/rental. There are so many snake-oil salesmen posing as DMEs I would not trust anything they say. I have called Medicare with questions, and they are very good at acting on your behalf and getting clear answers. My DME was trying to charge me a monthly fee for the modem on my device. That charge was not covered nor medically necessary. After informing the DME I should not be charged for something integral to the machine, and informing them I had no compliance monitoring requirement, I let Medicare take care of it. End of story. I got no more bills.
RE: Wiki conflict on Medicare/CPAP ownership - cps22 - 12-16-2023
I did not receive any letter. That is a quote from one of the wiki pages here. I was questioning why that page says "At the end of the rental time frame, the equipment will remain the property of the DME dealer, you will keep the device and all payments and copays stop."
Is that an error in the Wiki?
RE: Wiki conflict on Medicare/CPAP ownership - Nightynite - 12-16-2023
Thats a wiki error. At the end of 13 months your the owner, and no more payments to the DME from Medicare.
RE: Wiki conflict on Medicare/CPAP ownership - Opus1 - 12-16-2023
Be sure you are covered by traditional Medicare and not by Medicare Advantage.
Medicare Advantage plans have some degree of latitude regarding “rules” especially in the DME realm.
RE: Wiki conflict on Medicare/CPAP ownership - srlevine1 - 12-16-2023
I, too, was sent a letter that threatened that I would be responsible for any repairs after 13 months, but if I wanted to remain "covered" for any repairs, replacement, or temporary replacement during repair, I should choose to remain covered by the rental -- there would be no co-pay or other charges other than my supplies co-pay.
I opted for ownership. When my machine was replaced after five years, I had the motor replaced, the system cleaned and calibrated -- as a backup machine.
Be sure to demand a final bill of sale showing you own the machine after 13 months.
RE: Wiki conflict on Medicare/CPAP ownership - Sleeprider - 12-16-2023
The Wiki error was part of the article written in 2012. I don't know if there was a rule change or this was a mistake, but that section of the wiki has been removed. Thank you for bringing it to our attention.
RE: Wiki conflict on Medicare/CPAP ownership - cps22 - 12-16-2023
Thank you!
RE: Wiki conflict on Medicare/CPAP ownership - Sleeprider - 12-16-2023
After a little more research, this is the information that will be put in the wiki to replace the old text. Please let me know if you are aware of any changes I should make to this.
My DME sent me a notice that my CPAP is a "Capped Rental". What does this mean?
Medicare will pay a monthly rental fee for a period not to exceed 13 months. Original Medicare covers 80% of the cost of the monthly rental fee and the beneficiary or Advantage Plan will pay the 20% coinsurance. After the rental term ownership of the equipment is transferred to the Medicare beneficiary. During the rental period, copays and deductibles may apply. After ownership of the equipment is transferred to the Medicare beneficiary, it is the beneficiary’s responsibility to arrange for any required equipment service or repair.