April 12, 2022

Uncategorized

Pressure-Reducing Support System Covered with Part B

You asked, we answered! With Medicare Part B, pressure-reducing support services are covered, including certain beds (air-fluidized), mattresses, and mattress overlays.

What you need to know!

Pressure-reducing support services are categorized as durable medical equipment (DME) and therefore must be prescribed by your doctor for your use at home. Depending on what support service you are looking for, prior approval might be needed. Certain equipment is covered in different ways by Medicare; some equipment you have to rent, some you have to purchase, and some equipment you can have the option of either.

What will it cost you?

It’s important to know that DME will only be covered by Medicare if your doctor and medical supplier also participate in Medicare, so ask in advance. If your doctor isn’t covered, Medicare won’t pay for any claims submitted by them, and your doctor will have no limit for how much they charge you for the service. If your doctor is covered by Medicare they will then have to accept the assignment, this will ensure that the doctor is being paid directly by Medicare and you will cover the remaining 20% of the approved amount.

When looking into support services, to find out how much it will cost you, speak to your doctor directly before making a decision. Costs can change depending on several things:

  • Any other insurances you have
  • How much your doctor charges for the service
  • If your doctor accepts assignment
  • Type of facility
  • Where you are getting your DME

Sources

https://www.medicare.gov/coverage/pressure-reducing-support-surfaces

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