Medicare Beneficiaries Net 32% Savings on Medical Equipment and Supplies

Now that the first phase of the Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding Program is underway (as of January 1, 2011), Medicare beneficiaries in nine different areas of the country could see as much as a 32% savings on certain items.

“Through supplier competition, this new program set lower payment rates for certain medical equipment and supplies in nine competitive test areas,” says Alan Weinstock, insurance broker at MedicareSupplementPlans.com.

The nine initial test areas include:

1. Charlotte-Gastonia-Concord, NC/SC

2. Cincinnati-Middletown, OH/KY/IN

3. Cleveland-Elyria-Mentor, OH

4. Dallas-Fort Worth-Arlington, TX

5. Kansas City, MO/KS

6. Miami-Ft. Lauderdale-Pompano Beach, FL

7. Orlando-Kissimmee, FL

8. Pittsburgh, PA

9. Riverside-San Bernardino-Ontario, CA

The program will expand to 91 additional areas in the next phase of the program. In 2011, suppliers will compete to become contract suppliers for these 91 areas.

About the DMEPOS Competitive Bidding Program

This program changes the amount Medicare pays suppliers for certain durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) and make changes to which suppliers Medicare will pay to supply these items to Medicare beneficiaries.

The purpose is to replace the prices Medicare is currently paying with lower, more accurate prices. Suppliers now have to submit bids to furnish certain medical equipment and supplies at a lower price than what Medicare now pays for these items. Medicare uses these bids to set the amount it will pay for those equipment and supplies. Qualified, accredited suppliers with winning bids are chosen as Medicare contract suppliers.

The purpose is to save Medicare beneficiaries and the Medicare program money, reduce fraud and ensure Medicare beneficiaries have access to quality equipment and supplies.

Equipment and Supplies Covered in First Phase

The following categories of items are included in the first phase of the program:

1. Oxygen, oxygen equipment, and supplies

2. Standard power wheelchairs, scooters, and related accessories

3. Complex rehabilitative power wheelchairs and related accessories (Group 2 only)

4. Mail-order diabetic supplies

5. Enteral nutrients, equipment, and supplies

6. Continuous Positive Airway Pressure (CPAP) devices and Respiratory Assist Devices (RADs), and related supplies and accessories

7. Hospital beds and related accessories

8. Walkers and related accessories

9. Support surfaces (Group 2 mattresses and overlays in Miami-Fort Lauderdale- Pompano Beach only)

Medicare will only help pay for these items if they are furnished by contract suppliers. However, there are a few exceptions.

For example, you may be able to continue renting some types of medical equipment (including oxygen) from your current supplier, even if that supplier isn’t a contract supplier, if that supplier chooses to be a “grandfathered” supplier. Otherwise, the supplier is required to pick up the item from your home after the program begins.

For an in-depth look at the program check out “Your Guide to Medicare’s Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program.”

Medigap insurance can give what the original Medicare Supplement cannot and this is a very effective advantage of the Medigap insurance California.

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