In today’s modern society, more and more citizens are relying on home medical equipment to retain a high quality of life. Unfortunately, the landscape surrounding insurance coverage and associated benefits have led to a lot of confusion and anxiety for residents across Illinois. It falls on the patient to know what their insurance provider will cover, and each individual’s benefits will vary widely. If you’re looking for reliable and affordable medical supplies in Rockford, Lehan’s Medical Supplies & Equipment is here to help. Our experienced knowledgeable staff can work with you to find lift chairs, compression garments, support braces, breast pumps, CPAP machines, or nearly any other device needed to enhance the quality of your life.
One subject that has caused confusion in today’s insurance marketplace is durable medical equipment, or DME. Insurance benefits change from provider to provider, making it important for you to research your options before making a choice. Today, the Lehan’s team will highlight what qualifies as durable medical equipment and the value that our medical supply store can provide throughout the process.
What Is Durable Medical Equipment?
As the name implies, any supplies that are durable and intended for medical use tend to qualify as DME. It’s essential to know that durable medical equipment is different from prescription medication, and your provider’s coverage may vary drastically from pharmaceutical costs.
Medicare.gov is a trusted resource for our government’s views on medical coverages, and their definition of DME is the one commonly used across the industry:
- Durable. One-time supplies such as syringes are not intended for repeated use. Infusion pumps, however, deliver insulin over the course of years.
- Medically necessary. If a device is not being used for medical purposes, it will likely not be covered by your insurance. Most durable medical equipment requires the approval of a care provider before any insurance benefits are administered.
- Used at home. Your DME will generally be with you or in the home. Items such as crutches, hospital beds, and CPAP machines are good examples of home-centered medical supplies.
- Three-year lifespan minimum. Having a calendar minimum can help insurance companies to justify approval or denial of paying for a patient’s DME. Three years is the minimum, meaning that all medical supplies bought are intended for long-term use. Oxygen machines and wheelchairs are both products purchased to be utilized over a long span of time.
If you have Part B Medicare, the good news is that our durable medical equipment will be covered if approved. It is important to seek out a recommendation by a medical professional for your DME, as this approval is needed to begin the process.
It’s important to remember that these benefits are only available if your doctor and DME provider are both enrolled in the Medicare program. Normally, Original Medicare will determine a price that is acceptable for the equipment and you will be responsible for 20 percent of the cost. This occurs when your DME supplier is not currently participating in Medicare.
Patients may be required to rent, buy or combine the two per their DME plan. Keep in mind that suppliers that do not accept the assignment set by Original Medicare are free to charge you any amount.
Those with private coverage may not have DME per their provider’s coverage limits. Rising costs and the implementation of the Affordable Care Act (ACA) have led to reduced benefits by insurance providers looking to cut costs. If you’re a new mother, you will automatically qualify for needed items such as a breast pump. Those that need items such as walkers or mobility scooters to function are often facing higher and higher costs. Diabetics trying to pay for their medical supplies out of pocket may now be responsible for thousands of dollars annually. This is a big deal for patients who rely on these devices to happily and healthily.
More and more, patients are struggling to find healthcare solutions for their needed durable medical equipment.
Trusted Medical Supply Services in Rockford
Lehan’s is here to serve as your reliable source for durable medical equipment across Illinois, delivering cost-effective solutions for every customer we assist. Our team will work with your insurance provider to find the best strategy for optimizing your coverage while minimizing out of pocket responsibilities. We understand that insurance coverages can be complex, and getting to the true costs can often prove to be a difficult undertaking. Let Lehan’s Medical Supplies & Equipment in Rockford assist in providing top-quality durable medical equipment.
We provide a comprehensive inventory of DME, including:
- Compression socks
- Lift chairs
- Mobility scooters
- Sleep apnea devices
- Breast pumps
- Soft braces
If you live in Illinois and are not sure about your insurance coverages, be sure to stop by our medical supply store in Rockford for assistance. We’re open from 9 to 5 Monday through Friday, located next to the Walmart on Perryville Road. Call now for help!
Medical Supplies Rockford: Explaining Durable Medical Equipment And Supplies
If you’re looking for durable medical equipment, it’s important to know what qualifies as DME and what is covered based on your insurance. Learn more about insurance benefits by contacting us before stopping by our medical supply store for assistance!