Can I use any supplier I want?
In most cases, if you have Original Medicare, Medicare will only help pay for these items and supplies if they're provided by contract suppliers.
However, there are a few exceptions, like if you use a "grandfathered" supplier or if you get items and supplies from doctors or hospitals.
If your current supplier doesn’t get a new contract, you may still be able to stay with that supplier if they decide to participate in the program as a “grandfathered” supplier. Suppliers that don’t get Medicare contracts can decide to become "grandfathered" suppliers. This means a supplier may continue to rent equipment to you if you were renting the equipment when the program started. This rule applies to oxygen, oxygen equipment, and certain rented equipment. You may continue using the “grandfathered” supplier until the rental period for your equipment ends.
If you start renting additional equipment from a “grandfathered” supplier after the program starts, Medicare won’t pay for the new equipment.
If you’re renting equipment that’s eligible for grandfathering, your supplier will let you know in writing 30 business days before the program begins whether it will or won’t become a “grandfathered” supplier.
If your supplier doesn’t choose to grandfather, you’ll need to use a new contract supplier for Medicare to help pay for your equipment.
Equipment & supplies from doctors or hospitals
Medicare will help pay for a walker, folding manual wheelchair, or external infusion pump that your doctor or treating health care practitioner (including a physician assistant, clinical nurse specialist, or nurse practitioner) gives you, even if he or she isn't a Medicare contract supplier, as long as the walker is supplied in the office during a visit for medical care.
If you're admitted to a hospital and need a walker, folding manual wheelchair, or external infusion pump, Medicare will also help pay for it if the hospital gives it to you while you're admitted or on the day you're discharged from the hospital even if the hospital isn't a contract supplier.
What if I need a specific brand of equipment or supplies?
The Competitive Bidding Program has special protections to make sure you get the specific types of medical equipment you need to protect your health. If you need a specific brand of equipment or supplies, or you need an item in a specific form, your doctor must prescribe it in writing.Your doctor must also document in your medical record that you need this specific item or brand of supply for medical reasons. In these situations, a Medicare contract supplier is required to do one of these:
- Give you the exact brand or form of item you need.
- Help you find another contract supplier that offers that brand or form.
- Work with your doctor to find another brand or form that’s safe and effective for you.
Do I need to get my diabetes testing supplies by mail-order?
As of July 2013, Medicare has a National Mail-Order Program for diabetic testing supplies. No matter where you live, you’ll need to use a Medicare national mail-order contract supplier for Medicare to pay for diabetic testing supplies that are delivered to your home. If you don’t want diabetic testing supplies delivered to your home, you can go to any local store (local pharmacy or storefront supplier) that’s enrolled with Medicare and buy them there. The National Mail-Order Program doesn't require you to change your testing monitor. If you're happy with your current monitor, look for a mail-order contract supplier or local store that can provide the supplies you need.