CPAP’s are oxygen delivery system masks that help folks breathe easier. There is an entire regulation of what items and when you can purchase and or replace the working parts, or units in whole. Medicare will pay for many durable medic
al equipment needs but keep in mind that you need to follow the rules if Medicare is going to pay part or all of the expense. The chart below shows the parts and a time table of how often you can replace different items or parts when needed. The middle column HCPCS is short for “Healthcare Common Procedure Coding System”. This is the coding used by Centers for Medicare and Medicaid Services that identifies product and services used outside a doctor’s office or rather home or institutional care. This specific chart is for CPAP and related supplies.
As you can see this is a very detailed chart and timetable. There are many of these types of charts related to durable medical equipment of all types and sizes. These items cover everything from wheelchairs to insulin pumps and are very specific when reviewing coverage that is available from Medicare and Medicaid.
You can always check www.medicare.gov and the directory will give you specific direction of what is covered, who is approved to provide items and services, as well as how much for services and equipment you can expect to pay or have covered by CMS.
As far as what these services or equipment will cost you? It depends on what Medicare Advantage or Medicare Medigap (Supplement) plan you have contracted. This will vary by plan, not Insurance Carrier.
Remember with Medicare services and costs, it’s the plan, not the brand you choose!
(Previous published in the March 2016 Edition of the American Retirement Advisor Newsletter)