I have been on Medicare sense 2001 and never had a problem getting anything. Medicare pays 80 percent on all durable equipment for example walkers, canes, wheel chairs, commodes, bi-paps , hospital beds and so on . Some companies don't even bill for the balance Medicare does not pay. You can also get Medicaid . Medicare on Share Cost this plan does not go by income . they will pay th difference that Medicare does not.
When you need an item it must be medically necessary and have a script from a doctor . For a wheel chair you will want a company that makes them for people with ALS. Do you go to local ALS support meetings ? they can tell you who to use. If not email your local ALS association / and even ask for ALS care coordinator to come to your home. Also you can have your Dr. write scripts for you to go to Ot and PT. they will also recommend the proper type wheel chair even who to buy it from.
You are NOT to have to pay any money up front . When my wheel chair was ordered th first one ( Medicare had bought me two) th company sent a therapist to my home to evaluate me. Plus thy got records from my Doctors. Thy also go Dr.'s order. Then as soon as your wheel chair is done it should be given to you. By law they are NOT to bill Medicare until you have been given the chair. the company will bill Medicare, Medicare will pay their amount, and then if you have Medicaid too , Medicare will send the balance bill to Medicaid . they may even do this with your secondary insurance I am not sure as I have only had Medicare and Medicaid with share cost plan. After all this if a balance then the company may bill you.
You want to use companies that use Medicare only. These companies can only except the amount of money Medicare allows. For example a company bills Medicare, it will say on you statement Medicare approved amount, then Medicare will only pay 80 percent of that amount, then if you do not have any other insurance the company can bill you only 20 percent of the amount Medicare approved of. NO EXTRA. Medicare will send you statements, read them /check them make sure their OK. File and keep them. You can also open an account for your Medicare on line and See all this on line .
My second wheel chair I needed ASP. ( while waiting for first one I had a loner wheel chair) . I am 99 percent bed bound. So my hubby went to this company and picked out a pretty blue wheel chair small fit for me it was just right ! The wheel chair company called my Dr. got script faxed over ( mean time they gave me a loner ! ) then there was medical Necessary papers that needed filled out. My Dr. comes out to home reads the questions fill out with me so it took about 5 days. As soon as they had it they brought me my new wheel chair ! they did th billing then. Medicare paid 80 percent and Medicaid paid 20 percent . As easy and fast as could be !
You do not nd to b doing any billing yourself or paying any money up front. Sense I've been on Medicare 2001 I have never had to pay anything except $68.00 to my Dr's office and my co-pays for meds. My co-pays are like $2.50 for generic and ;less than $6.00 for other meds like Rilutek ..
If you do not have Medicare Part D for medications you will want to get this .
I hope I explained this OK. You do not have to do any billing yourself. You do not have to pay any money up front to anyone. the companies you buy from will take care of all that. Those companies also are not to bill Medicare and other secondary insurances until the wheel chair and other times have been delivered to you. If you are dealing with a doctors office, or company for durable equipment that does not except Medicare and do th proper method of billing change companies.
