On July 1, 2013 the government expanded its competitive bidding program for durable medical equipment, prosthetics, orthotics and supplies — everything from diabetic test strips and back braces to mattresses and motorized scooters — to 100 metropolitan areas nationwide.
The government estimates that it will save taxpayers $25.7 billion over 10 years and beneficiaries an additional $17.1 billion in out-of-pocket costs.
Here are answers to questions you may have about how the program could affect you.
How can I find out if I will be affected?Call 800-633-4227 or visit medicare.gov/supplierdirectory and enter your ZIP code. You'll then know whether you live in one of the 100 competitive bidding areas and which types of equipment and supplies are covered.
Will I have to use one of the new Medicare contract suppliers or can I continue with my current supplier?
You can also get the supplies from a store or pharmacy that accepts "Medicare assignment." This means that the store will accept the Medicare-approved amount as payment in full and that you cannot be charged more than a 20 percent copay (after you meet your annual deductible). A Medicare contract supplier can't charge you more than that for the equipment or supplies included in the competitive bidding program.
What about equipment and supplies I get from my doctor or hospital?
What if I'm in a Medicare Advantage Plan?
What if I need a specific brand or form of equipment or supplies?Your doctor must prescribe the specific brand or form in writing and note in your medical record why it's needed. Then, a Medicare contract supplier is required to furnish that brand or form, help you find another contract supplier that can furnish it, or work with your doctor to find a safe and effective alternative.
What happens if I need to get medical equipment or supplies when I'm away from home?If you are in a competitive bidding area while away from home, you'll need to use a Medicare contract supplier for any covered equipment or supplies, and your out-of-pocket costs will be the same as when you are home. If you're not in a competitive bidding area, you may use any Medicare-approved supplier.