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+--- Thread: Has anyone received Medicare reimbursement for purchased CPAP or subsequent supplies? (/Thread-Has-anyone-received-Medicare-reimbursement-for-purchased-CPAP-or-subsequent-supplies)
Has anyone received Medicare reimbursement for purchased CPAP or subsequent supplies? - gbecsi - 05-30-2024
I'm familiar with Medicare's policy to rent the machine for 13 months before owning, and the compliance requirements that go along with that.
I've also read several posts and articles about how to request reimbursement from Medicare on a CPAP you've previously purchased, and that it might or might not work.
Two questions:
-- Has anyone actually received reimbursement from Medicare on a previously purchased machine?
-- Has anyone been successful at having Medicare pay for ongoing supplies for a machine you already own? If so, what was required?
I purchased an AirSense 11 and have been using it consistently and successfully for 2-3 months. The reason I didn't go through Medicare was for convenience during a time when all of my time and energy was going towards helping three family members through major surgeries (including my spouse's pancreatic cancer). I didn't want to ignore my own health, but I didn't have it in me to deal with DMEs, rental contracts, backorders,.etc. Things have since returned to somewhat normal and I'm now retired, so I'm researching the options for going forward, at least for supplies if not reimbursement on the major purchase.
I'd really appreciate hearing from anyone who's been in a similar situation.
RE: Has anyone received Medicare reimbursement for purchased CPAP or subsequent supplies? - Sleeprider - 05-30-2024
You can always get supplies for your existing CPAP which was obtained through a prescription based on your doctor's determination you would benefit from the therapy. You may need to have a new prescription for the supplies and be able to document use and necessity. I don't think you will get reimbursement for a purchase that did not involve prior claim approval, but I have not researched that option.
RE: Has anyone received Medicare reimbursement for purchased CPAP or subsequent supplies? - Big Guy - 05-30-2024
When I was prescribed a CPAP machine back in Sept. of 2018, Medicare and my supplemental insurance (BC/BS) covered it all, with the exception of $68.00 I think it was.
I'm still receiving supplies to this very day at no cost. I have a ton of new equipment on hand. I get supplies about every three months or so.
My family doctor says it's time for a new CPAP machine, as mine is older than 5 yrs. He's supposedly going to do the paperwork for one.
RE: Has anyone received Medicare reimbursement for purchased CPAP or subsequent supplies? - gbecsi - 05-30-2024
Thanks - Yes, I'm figuring I won't get reimbursement on the machine. (I did buy it with a prescription from a pulmonologist after a sleep test.)
I contacted the CPAP coordinator at their office a few days ago to ask about having future supplies put through Medicare, and she said I would have to set up another in-person appointment with them, timed with either sending them a copy of the SD card or a compliance report from MyAir. The report isn't a problem, but it bugs me that I have to have another appointment even though I just had the test and got the prescription a few months ago.
RE: Has anyone received Medicare reimbursement for purchased CPAP or subsequent supplies? - HalfAsleep - 05-30-2024
My DME is tolerable. I've actually been very pleasantly surprised. The last one I had was awful. Medicare and supplement paid 100% of equipment and supplies.
I don't think you can get reimbursement on the machine, but you could always get a new one from Medicare and sell the old one. I don't believe Medicare would cover the machine, but definitely they would cover supplies. The folks that need the most supplies long-term are beyond the compliance period and own their machines: no reason for them not to cover supplies, I am guessing. Online stores offer supplies purchased with Medicare, so it's possible you could avoid a DME entirely.
RE: Has anyone received Medicare reimbursement for purchased CPAP or subsequent supplies? - gbecsi - 05-31-2024
Interesting. I'll check into that. Thanks.
RE: Has anyone received Medicare reimbursement for purchased CPAP or subsequent supplies? - ischua - 06-01-2024
Finding a good DME is like finding a good car mechanic. I've dealt with some bad ones. The one I use now is wonderful I order parts when I need them not when they decide I do. I just pay my medicare deducible and shipping depending on what I get. They ask a few questions and are attentive to my needs. (my only gripe is a minimum for free shipping) and they NEVER bother me. I had my doctor send in a prior authorization to get some reimbursement but not much. Easier to do before you shell out of pocket.