Can I use any supplier I want?
In most cases, if you have Original Medicare coverage, 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 you’re already renting certain equipment that's paid on a monthly basis when the program starts, you may be able to stay with your current supplier. Suppliers that aren't Medicare-contract suppliers can decide to become "grandfathered" suppliers for certain rented items and supplies, like CPAP devices, oxygen, and oxygen supplies.
If a "grandfathered" supplier rented the equipment to you at the time the program started, Medicare will pay for the supplier to continue to rent to you. You may continue using that supplier until the rental period for your equipment ends.
If you start renting additional equipment from a "grandfathered" supplier after the program started in your area, 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.
Items & supplies from doctors or hospitals
Medicare will help pay for a walker 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, 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 for my items & supplies?
If you need a specific item or brand of supply, or 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:
- 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 will have 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. This new 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.