You ask, we answer! Knowing that you have lots of questions, we provide answers at a glance. At Legacy, our desire is to have open, straightforward communication with our customers, giving them the power to make educated decision about their health. If you have any additional concerns that are not addressed in this section, please use a contact form, e-mail, or call us at anytime
Q1: What is durable medical equipment (DME)?
A1: Durable medical equipment is equipment used in the home to treat an underlying medical condition.
Q2: Will my insurance pay for durable medical equipment?
A2: While most insurances that cover doctor’s office visits will usually cover durable medical equipment, it is always best to check with your insurance company to see if it is covered under your policy.
Q3: Does Medicare rent or purchase DME?
A3: Medicare will purchase items such as walkers, bedside commodes and canes, but bigger items, such as wheelchairs, hospital beds, and CPAPs are rent to purchase.
Q4: What is “rent to purchase”?
A4: Rent to purchase means that Medicare will rent an item for 13 months and then they consider the item purchased and it belongs to the beneficiary.
Q5: What about oxygen?
A5: Home oxygen equipment is never purchased by Medicare. Medicare will pay a total of 36 rental months and then no payment is received for the next 24 months, for a total of 60 months. During that time, your level of service remains the same. This means that, if you were receiving portable tanks during the first 36 months, you will continue to receive them. We will continue to do routine maintenance and service. At the end of 60 months you may receive a new concentrator and the billing cycle starts all over again. The equipment remains the property of the DME provider.
Q6: How much will I have to pay?
A6: This varies depending on your insurance coverage. Very few insurance policies pay 100% of charges. If you have private insurance, you need to check with them to see what percentage they pay. Medicare pays 80% of their allowable charges. That means that you are responsible for the remaining 20%. If you have a Medicare supplement it may pay all or part of that amount. There is also a yearly deductible that most insurances make you pay.
Q7: If I have something such as a suction machine or CPAP, will my insurance pay for the related supplies?
A7: Medicare and most private insurances will pay for all related supplies as long as you qualify for the machine.