Medicare Part B (Medical Insurance) will cover walkers – including rollators – as durable medical equipment (DME), that are prescribed by your doctor for use in your home. Therefore, if you are covered by Medicare Part B, or if you have Part B coverage via a Medicare Advantage Plan, then you are eligible for this benefit.
If a medical equipment supplier accepts Medicare assignment, then you will be required to pay 20 percent of the Medicare-approved amount. In addition, the Medicare Part B annual deductible will also apply. In 2015, the amount of this deductible is $147.
It is important to note that Medicare will oftentimes pay for different types of durable medical equipment in different ways. For example, depending on the type of equipment, you may need to rent it, or you may need to buy it. Or, you may have the choice of either renting or purchasing it.
How Do You Know If You Are Covered?
Medicare will only cover the cost of your durable medical equipment if your health care providers and durable medical equipment suppliers are enrolled in Medicare. This means that they accept Medicare assignment.
In order to accept Medicare assignment, these medical providers and suppliers are required to meet strict standards. If these entities are not enrolled, then Medicare will not pay the claims that are submitted by them.
It is important that you ask your doctors and / or durable medical equipment suppliers if they accept Medicare assignment and if they are enrolled in Medicare prior to purchasing any equipment from them. This is because suppliers that do not accept Medicare can charge an unlimited amount for the equipment that they sell to you.
What is the Competitive Bidding Program?
If you reside in or visit certain areas of the United States, you could be affected by the Medicare Competitive Bidding Program when it comes to obtaining a walker, or any other durable medical equipment. Medicare is phasing in this program in some areas of the country. This program changes the amount that Medicare pays suppliers for certain durable medical equipment (DME), and it also changes who may supply these items.
Under this program, suppliers submit bids in order to set the amount that they pay for the equipment and supplies. The qualified, accredited suppliers that have winning bids are then chosen as Medicare contract suppliers.
The Competitive Bidding Program is meant to help Medicare enrollees and Medicare save money. It also is intended to provide Medicare enrollees access to quality medical equipment, supplies, and services from trustworthy suppliers. In addition, the program may also help in limiting fraud and abuse within the Medicare program.
If you are enrolled in Medicare Part A and Part B (Original Medicare) and you get competitively bid equipment and supplies in competitive bidding areas, then Medicare may only help to pay for these equipment and supplies if they are provided by contract suppliers.
A contract supplier is not allowed to charge you more than the 20 percent co-insurance amount and any unmet annual deductible for any equipment or supplies included in the Competitive Bidding Program.
In order to determine how much a specific item will cost, talk to your doctor or other health care provider. This is because the specific amount that you owe can depend on a variety of different factors, such as other insurance that you may have, how much the supplier charges, and / or where you obtain your item.