If the competitive bidding demonstration program does not affect you, you will pay the least for your DME if you use suppliers who accept Medicare assignment. You are not affected by the demonstration if you
- Live in (or travel to) an area that is outside of the demonstration or
- You need equipment, such as nebulizer equipment and supplies, even though you live in a competitive bidding area.
Even if you do not live in a competitive bidding area, you should still call 800-Medicare or go to www.medicare.gov/supplier to find a list of suppliers who accept assignment in your area. Suppliers who accept assignment agree to accept Medicare’s approved amount for the item as full payment. Medicare will pay the supplier 80 percent of its approved amount (after you meet your Part B deductible) and you or your supplemental insurance pays a 20 percent balance.
Be aware that many suppliers are approved by Medicare but do not accept assignment. You typically pay more if you use these suppliers. They are not limited in the amount they can charge you after Medicare pay its 80 percent share.
Suppliers who have not signed up with Medicare
Avoid suppliers who have not signed up to bill Medicare for DME. Medicare will not pay anything for your DME if you use a supplier who cannot bill Medicare.
Note that if you use a supplier who is not approved by Medicare, the supplier must let you know this ahead of time and tell you Medicare will not pay. The supplier should have you sign an Advanced Beneficiary Notice (ABN). This notice states that you are aware that Medicare will not cover the DME and you will be responsible for the full cost. If the supplier does not have you sign an ABN, you do not owe the supplier for the cost of your DME.
Additional coverage rules apply for Medicare coverage of wheelchairs and scooters. Please click here for more information.