older couple with home care equipment representative

Who Pays for Home Care Equipment and Supplies?

There are a few government programs that can help those who are eligible. Some private insurance policies also cover a portion of the cost for equipment. It is important to remember, however, if seeking reimbursement for purchase or rental, a doctor’s order is always needed prior to making the agreement to rent or purchase.

Medicare

Medicare Part A

If a person has Medicare Part A and qualifies for the Home Health Benefit (patient must be incapable of leaving his/her residence, requires skilled nursing care and does not require only custodial care) then Medicare will cover 80 percent of the allowable amount for medically necessary durable medical equipment. (Each state sets its own allowable amount for each item.)

Medicare Part B

If a person has Medicare Part B, he/she does not have to qualify for the Home Health Benefit and Medicare will cover 80 percent of the allowable amount for medically necessary durable medical equipment.

Medicare does not usually cover:

    • Hearing aids
      Home adaptation (lifts, grab bars for bathroom safety, ramps)
      Disposable medical supplies (some exceptions for diabetic, ostomy and feeding tube patients)

Medicaid

If a person qualifies for Medicaid, it generally covers a wider selection of equipment and supplies and a larger portion of the expense than Medicare. Medicaid also does not have the same strict limitations on duration of use and the number of supplies as does Medicare.

Veterans Administration

The Veterans Administration (VA) is particularly helpful in providing durable medical equipment to those who qualify. Veterans or the spouse of a veteran may be eligible for benefits.

Long-Term Care Insurance/Health Insurance

Some disease-specific or medically necessary supplies are partially covered by some private insurers. Coverage is either based on the individual’s coverage, or, if the person seeking coverage is a dependent, then check the family policy to see if it covers dependents, as it may cover health care equipment for dependents as well.

Note: Although having the insurer pay for some of the cost may seem like the best deal, it may not be. It is possible that purchasing the item at an “out of network” vendor whose price is lower could be the more affordable option.

Private Funds

Many disposable home care supplies and assistive devices are available through mail order catalogs or medical supply and home care product companies on the Internet. For home care equipment that is not covered through insurance, check into equipment rental options or private market resale of previously owned items such as wheelchairs, scooters and handicap vans. Used equipment advertisements can be found in disability newspapers as well as on websites such as CraigsList.org, ebay.com, and UnitedAccess.com.

For a free in-home care assessment, contact us today. Besides offering traditional home care services, we can make recommendations for assistive devices, supplies and equipment, arrange for order and delivery and answer all of your home care equipment questions.

Source: AgingCare