Home Medical Equipment Insurance & Billing FAQs

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Will my insurance or Medicare pay for any medical equipment I need?

This is first and foremost dependent on your insurance provider. You can consult your policy or contact your insurance provider to find more details on specific products. If your provider covers the items you need, you will then need to find a retailer who bills your provider. Many retailers bill insurance companies, but most retailers don’t bill every provider. Call the retailer before you go to make a purchase—it could save you a lot of time!

What medical equipment does my insurance pay for?

Another question that needs to be answered by your insurance provider. The most commonly prescribed pieces of medical equipment for home use are:

• Wheelchairs
• Walkers
• Hospital beds & mattresses
• Mobility scooters (power or specialty scooters like knee walkers)
• Rehab and post-op aids
• Bathroom safety aids
• Canes and crutches
• Lift mechanisms (Hoyer-style lifts and the motors in power lift recliners)
• Compression hosiery

If you have a decent plan with your insurance provider, chances are you can get an item in one of these fields covered. The above list is not comprehensive, however, and every provider is different. Always make sure to speak to your insurance provider if you are unsure.

Do I need a prescription to have an item covered by my insurance provider?

Most home medical equipment does not need a prescription in order to be billed to your insurance provider. You should always make sure the item is covered before you purchase it. Calling your insurance provider is the best way to make sure you won’t end up footing the bill for a piece of medical equipment.

My doctor recommended a product but did not write a prescription. What should I do?

If you remember the product (be 100% sure!) then this is not a problem—without a specific prescription, you can pick the product you like! Make absolutely sure that the item you are purchasing is covered by your insurance provider. You don’t want to pay for a premium item if you don’t have to.

If you don’t remember the product, give your doctor’s office a call. When a doctor recommends an item without a prescription it is an OTC (over-the-counter) item. Many nurses and even some office staff members can answer your question. Sometimes you won’t even have to wait for a call back from your doctor.

What can I do if my insurance provider does not cover an item?

There are many answers to this question, but the answer you’re looking for depends on your situation. If the item you need is a ‘common’ item (walker, wheelchair, compression stocking, etc.), you may be able to purchase a different/cheaper version of the prescribed item. If you find a different version, your insurance provider may cover the new item. Cheaper items can be found, which may be better choices when making a cash purchase. Always consult your doctor if you are looking for an item on a prescription.

If you need financial help, there are a few options as well. There are several medical credit agencies that provide credit for medical items. If you don’t want to immediately jump on the credit ship, take a look at manufacturer or retail coupons. Many local retailers are able to set up payment plans for some items.

For items needed for short periods of time, you should always look at rental options. Most rental medical items are not covered by insurance, but the rates are so cheap (comparative to purchasing), that it could save you a lot of time and money.

Are there any items that I should self-pay for?

There are a few items that are almost always a waste of time to bill to an insurance provider. Canes and crutches are at the top of the list. Brand new canes retail for anywhere from $10-15, if you aren’t looking for any fancy features. New crutches retail from $15-30, depending on sizes (regular crutches only, there are some very nice ‘athletic’ style crutches that are much more expensive).

Accessories, especially ‘comfort’ accessories like cushions and padding, are usually not covered by insurance providers. Most accessories are extremely affordable. If you need a quality of life boots in the form of a cushion or seat cover, it is always worth it; don’t wait for the paperwork to go through and potentially save you $20—spend the $20 upfront and be comfortable during your whole time of need.

Does Oswald’s Bill Insurance for Medical Equipment?

Oswald’s does not submit insurance or Medicare/Medicaid claims for most products. If you have specific questions on a product or would like to know what forms will help your self-billing claims, don’t hesitate to give us a call or send us an email. We’re open 7 days a week!