Frequently Asked Questions
What equipment does my insurance cover?
Generally, insurances cover durable medical equipment (DME) that your doctor prescribes for use in your home. DME is "durable," used for a medical reason, not usually useful to someone who isn’t sick or injured and is to be used within the home.
If I have Medicare, how do I get DME?
If you need DME in your home, your physician (or a nurse practitioner, physician assistant or clinical nurse specialist) must prescribe the type of equipment you need by filling out a detailed written order. Medicare will also require your doctor to provide your medical records showing the medical need for the DME.
What is a detailed written order?
A detailed written order is the prescription to confirm what is ordered by the treating physician. This must include the name of the patient, date of birth (DOB), a detailed description of the item, length of need (if applicable), physician’s detailed information, physician’s signature and date.
What if I need DME and I’m in a Medicare Advantage Plan?
Medicare Advantage Plans (like an HMO or PPO) must cover the same items and services as Original Medicare.
What insurance plans do you accept?
Home Support accepts most major insurance plans. Please contact our office or your insurance company to see if we are in network with them.
How much will I have to pay?
Generally, you pay 20% of the Insurance-approved amount after you pay your deductible for the year. Your insurance generally pays the other 80%. Your insurance is responsible for setting the amount you owe.
What is a deductible?
A deductible is the amount you have to pay out-of-pocket for expenses before the insurance company will cover the remaining costs.
How will I know if I can buy DME or whether my insurance will only pay for me to rent it?
If your supplier is a Medicare-enrolled supplier, they’ll know whether your insurance allows you to buy a particular kind of DME, or just pays for you to rent it. Most insurances pay for DME on a rental basis. The decision as to what can be rented or bought is made solely by your insurance company.
What does the rental mean?
If you rent to purchase DME and other devices, your insurance makes monthly payments for use of the equipment. The rules for how long monthly payments continue vary based on the type of equipment.
How long does my DME rent?
The length of the rental depends on the type of DME. Some rentals are a little as 9-13 months and some rent as long as the DME continues to be medically necessary. If the equipment is not a continuous rental, the equipment will rent to purchase and you will own the DME at the end of the rental.
What is an Advance Beneficiary Notice of Noncoverage (ABN)?
If you have original Medicare and your supplier thinks Medicare probably won't pay for items or services, they may give you a written notice called an "Advance Beneficiary Notice of Noncoverage" (ABN). This form lists the items that Medicare isn't expected to pay for, an estimate of the costs, and the reasons why Medicare will not pay. The purpose of the ABN is to give you the ability to make an informed decision on whether to get the item or service that may not be covered and accept financial responsibility when Medicare does not pay.
I was told by my
insurance company it would be covered, why do you say differently?
Many insurance companies will tell you DME is covered when you call to inquire. What they may not tell you is that there are medical necessity criteria that must be met. They may require additional medical records to show that your meet their criteria. Once we receive a detailed written order, we will check with your insurance company to find out what information is needed and do our best to obtain that information from your physician. Once we have the required information we will submit it to your insurance company to show you meet their criteria.
Customer Service Questions
How do I get equipment or services?
Normally we receive an order from your healthcare provider. The order is sent directly to us or you can walk in with the order or prescription. A staff member will submit a request for authorization to Medicaid, Medicare, or private insurance before providing equipment.
Do I need an order or prescription from my physician to receive equipment?
Most of the time the answer is yes. There is some equipment that can be purchased over the counter. However, the majority of what we provide requires a detailed written order.
What is your return policy?
Items must be returned within 5 working days for credit to the account.
What if I have a problem with my equipment outside of regular hours?
Our office is open Monday through Friday from 8:00 am to 4:30 pm. However, we have staff on call every day of the week to assist you with any problems that may arise.
My physician’s office sent my order to your office two days ago. Why do I still not have my equipment?
We make every effort to get your equipment to you as soon as possible. However, sometimes there are issues that hold up dispensing equipment. These include an order or prescription that did not have the needed information, lack of insurance information, or other incomplete or missing documentation. Please be assured that we are working to get all paperwork in place.
I have a prescription for compression stockings. Can I just bring it in the office?
When you have a prescription for compression stockings bring it in our office and one of our trained staff will measure you to make sure you get a proper fit. Please come in between 8:00 am and 10:00 am to insure proper measurement. After 10:00 am swelling may prevent accurate measuring.
Will insurance or Medicare cover my compression stockings?
Our staff will check
to see if your insurance will cover your compression stockings. There are some
insurances that do cover compression stockings, but Medicare will not.
What if I want to switch to your company from another provider?
Please call our Intake
Specialist between 8:00 am and 4:30 pm Monday through Friday for assistance
with the process of switching providers.