Do you or your loved one need more stability in the shower or tub? Do you or the loved one need a walker, a rollator or a power scooter to get around? Then it’s likely that you’ll soon be in the market for what’s referred to assistive devices or durable medical equipment (DME). If so, it’s also likely that you might be left wondering how to pay for these often very expensive devices and if the cost will be covered by your health insurance or Medicaid/Medicare.
Like in-home care services, there are several different options when it comes to paying for home care equipment and supplies. The following are some of the options available to help you or a loved one purchase DME equipment:
If a person has just Medicare Part A and qualifies for the Home Health Benefit, then Medicare will cover 80 percent of the allowable amount for any “medically necessary” DME equipment. (Usually, the person’s medical provider decides what is medically necessary and whether or not the patient qualifies for the Home Health Benefit.) On the other hand, if a person has Medicare Part B, he or 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.
Medicaid typically covers a wider selection of home care equipment and does not have as many strict requirements or limitations on DME as Medicare does. However, state Medicaid programs usually have very stringent financial qualifications it requires of its residents before individuals are approved for services of any kind under Medicaid.
Veteran’s Administration (VA)
The VA is particularly helpful in providing durable medical equipment to those vets and surviving spouses who qualify. Veterans or the spouse may be eligible for benefits. You can learn more by calling the North Idaho Veterans Service Office (VSO) at (208) 446-1090 or go online at www.va.gov/opa/publications/benefitsbook/benefitschap01.asp.
Other Ways to Pay for Home Care Equipment
If you do not qualify for Medicare or Medicaid, or receive benefits from the Veteran’s Administration, there are some other options to help you pay for home care equipment. Here are some tips for using your long-term care or health insurance and private funds to afford the equipment you need:
1. Long-Term Care Insurance/Health Insurance
If the equipment or supplies you need are “medically necessary,” they may be 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.
Keep in mind that while having your insurance company pay for some of the cost may seem like the best deal, it may be possible to find the items you need at an “out of network” vendor with a lower price so that your “out of pocket” costs are actually less than if your insurance paid for the items.
2. Private Fund
If you need home care equipment that is not covered under private insurance, consider looking into equipment rental options or previously owned items, such as wheelchairs, scooters and handicap vans. Used equipment advertisements can be found advertised in disability newspapers as well as on websites, such as, www.Craigslist.org, www.ebay.com, or www.unitedaccess.com.
If you would like information on finding a local home care equipment company for a loved one, contact us today. We can make some equipment recommendations, based on the client information you provide and answer any other home-care related questions you might have. We can be reached at 208-777-0308 if you’re calling from the Post Falls, Coeur d’Alene or Hayden areas; 208-263-7889 in the Sandpoint, Bonners Ferry or Priest River areas; or 208-784-1505 if you’re calling from the Kellogg, Pinehurst or Wallace areas. If calling from outside any of these areas, call us toll-free at 877-464-2344. We would be happy to answer any of your questions regarding home care.