Medicare Insurance

Medicare Insurance for Durable Medical Equipment

Capped Rental Items:

Includes hospital beds, wheelchairs, alternating pressure pads, air-fluidized beds, nebulizers, suction pumps, continuous airway pressure (CPAP) devices, patient lifts and trapeze bars.

  • Medicare will pay a monthly rental fee for a period not to exceed 13 months.
  • After 13 months, the ownership of the equipment is transferred to the Medicare beneficiary.
  • After 13 months it is the beneficiary’s responsibility to arrange for a required equipment service or repairs.

For Example, to get approved for a manual wheelchair thru Medicare:

Manual Wheelchair (k1-Standard)

Included in this package:

  • Standard frame (16X16, 18X16, 20X16)
  • Standard arm rests (desk or full)
  • General use seat cushion (3”)
  • General use back cushion
  • Seat belt
  • Anti- tippers
  • Brake extensions
  • Standard footrests

(elevating footrests available with DX of fracture or edema)

* If your patient has MEDICARE only (part B):

Please note this is a rental for 13 months

Please expect a first month’s co-pay of $72.61

Each additional month is $10 or less.  (Towson Medical is the only DME company to offer a prepayment discount)

Included in the Required Paperwork Packet:

  • A detailed written order
  • A face-to-face form
  • Medicare’s requirements of what MUST be included in the patient’s chart notes.

DOCTOR’S MUST PROVIDE CHART NOTES (NOT THIS SHEET) THAT ADDRESS ALL OF THE FOLLOWING:

  1. The patient has a mobility limitation that significantly impairs his/her ability to participate in one or more mobility-related activities of daily living (MRADLs) such as toileting, feeding, dressing, grooming and bathing in customary locations within the home.
  2. The patient’s mobility limitation cannot be sufficiently resolved by the use of an appropriately-fitted cane or walker, and the use of a manual wheelchair will significantly improve the patient’s ability to participate in the MRADLs.
  3. The patient’s home provides adequate access between rooms, maneuvering space, and surfaces for the use of the manual wheelchair that is provided.
  4. The patient will need to use the manual wheelchair on a day to day basis within the home, and is willing to do so.
  5. The patient has sufficient upper extremity function and the other physical and mental capabilities needed to safely provide a manual wheelchair (limitations of strength, endurance, range of motion or coordination, presence of pain, or deformity or absence of one or both upper extremities are relevant to the assessment of upper extremity function) OR has a caregiver who is available, willing and able to provide assistance with the wheelchair.

IF THE PATIENT REQUIRES ELEVATING LEG RESTS:

  1. The patient has a musculoskeletal condition or the presence of a cast or brace which prevents 90 degree flexion at the knee OR the patient has significant edema of the lower extremities that requires an elevating leg rest.

* All documents must be signed by the same provider.

* Provider must be PECOS certified.

For inexpensive or Routinely purchased items:

Includes canes, walkers, crutches, commode chairs, low pressure and positioning equalization pads, home blood glucose monitors, seat lift mechanisms, pneumatic compressors, bed side rails, and traction equipment.

  • This medical equipment can be purchased or rented, however the total amount paid for monthly rentals cannot exceed the fee schedule purchase amount.