Infusion pumps & supplies
Medicare Part B (Medical Insurance) covers equipment and supplies for home infusion therapy
Description
Infusion pumps and supplies help administer certain IV infusion drugs.
Coverage details
Part B covers equipment and supplies (like a pump, IV pole, tubing and catheters) for home infusion therapy if your doctor or other health care provider prescribes them for use in your home. Medicare also covers related services (like nurse visits), training for patients or caregivers, and monitoring.
The infusion drugs and certain equipment and supplies (like the infusion pump) are covered under the durable medical equipment (DME) benefit.
Medicare covers different kinds of DME in different ways. Depending on the type of equipment:
- You may need to rent the equipment.
- You may need to buy the equipment.
- You may be able to choose whether to rent or buy the equipment.
- Some items become your property after you’ve made a certain number of rental payments.
Who's eligible
Part B covers medically necessary DME if your provider prescribes it for use in your home.
Provider requirements
Make sure your doctors and DME suppliers are enrolled in Medicare. It’s also important to ask your suppliers if they participate in Medicare or will accept assignment of your claims before you get DME.
Costs
After you meet the Part B deductible , you pay 20% of the Medicare-approved amount (if your supplier accepts assignment).
If suppliers are participating in Medicare, they must accept assignment (which means, they can charge you only the coinsurance and Part B deductible for the Medicare-approved amount). A non-participating provider doesn't have to accept assignment of your claims, but may choose to do so in your case.
If DME suppliers aren't participating suppliers or won't accept assignment of your claims, you may be charged more. For rented DME, make sure the supplier is willing to accept assignment of your claims for all rental months. If the claim isn't assigned, you must pay for the full cost upfront. If this happens, Medicare will pay you later for the amount it covers after your claims have been processed.