Your Medicare Coverage
Is my test, item, or service covered?
Enteral nutrition equipment (feeding pump)
How often is it covered?
All people with Medicare are covered.
Your costs in Original Medicare
You pay 20% of the Medicare-approved amount . Medicare pays for different kinds of DME in different ways: some equipment may be rented, other equipment may be purchased, and you may choose to rent or buy some equipment.
Medicare will only cover your DME if your doctor or supplier is enrolled in Medicare. If a DME supplier doesn't accept assignment , Medicare doesn't limit how much the supplier can charge you. You may also have to pay the entire bill (your share and Medicare's share) at the time you get the DME.
Competitive Bidding Program
If you live in or visit certain areas, you may be affected by Medicare's Competitive Bidding Program. In most cases, if you have Original Medicare and get competitively bid equipment and supplies in competitive bidding areas, Medicare will only help pay for these equipment and supplies if they're provided by contract suppliers. Contract suppliers can't charge you more than the 20% coinsurance and any unmet yearly deductible for any equipment or supplies included in the Competitive Bidding Program.
Depending on how long you've been renting your equipment, you might not need to get it from a contract supplier.
- If you've been renting an enteral infusion pump on a continuous basis for more than 15 months, your supplier must continue to provide you with the pump as long as it's medically necessary even if the supplier isn't a contract supplier. If your current supplier isn't a contract supplier, it isn't allowed to pick up the pump from you because Medicare is still covering it.
- If you've been renting an enteral infusion pump for less than 15 months, and your current supplier isn't a Medicare-contract supplier under the new program, then you'll have to change suppliers. However, your current supplier isn't allowed to pick up any equipment or supplies from you until the last day of the last rental month that began before July 1, 2013. Your current supplier and your Medicare-contract supplier must work together and coordinate to make sure you have the equipment you need. For example, if you’ve paid for a rental pump with your current supplier through the end of December, they must continue to provide the equipment you need through December 31 and make sure they work with your new supplier so that you don't have any interruptions in service.