Pressure-reducing support surfaces
Medicare Part B (Medical Insurance)
covers pressure-reducing support surfaces
durable medical equipment (DME)
that your doctor or other health care provider prescribes for use in your home
Description
Pressure-reducing support surfaces include certain beds (like air-fluidized beds), mattresses, and mattress overlays that prevent or treat pressure sores or ulcers.
Coverage details
You’ll have to get prior approval for certain types of pressure-reducing support services (like powered air flotation beds).
If you live in certain states, you may have to get prior approval for 5 types of pressure-reducing support surfaces.
Medicare covers different kinds of Durable Medical Equipment (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.
Provider requirements
Make sure your doctors and DME suppliers are enrolled in Medicare. It’s also important to ask a supplier if they participate in Medicare 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). If suppliers aren’t participating and don’t accept assignment, you may have to pay for the full cost of the DME.
Ask your doctor or healthcare provider how much your test, item, or service will cost.
Your doctor may recommend services that Medicare does not cover or offers too frequently. This could end up in additional costs for you. Make sure to ask your doctor about the reasons for these recommendations and what Medicare will actually cover.
Specific amounts you could owe depend on:
Other insurance you may have
How much your doctor charges
If your doctor accepts assignment
The type of facility
Where you get your test, item, or service