From the Health Care Financing Administration

Medicare pays for durable medical equipment in different ways, depending on the item or service (service includes service calls for repair and routine maintenance) and whether you buy or rent the equipment.

Medicare pays the same amount whether the supplier "takes assignment" or not. If the supplier takes assignment and if you have already met your deductible for the year, Medicare pays 80 percent of the Medicare approved charge... and you're responsible for the remaining 20 percent. You may pay more if the supplier does not take assignment.

Assignment means that the supplier agrees to accept the Medicare-approved amount as payment in full. Not all suppliers accept assignment. If you buy equipment from a supplier who does not take assignment, Medicare will still pay only 80 percent of the Medicare-approved amount. You are responsible for the difference between what Medicare pays and what the supplier charges.

Whether the supplier takes assignment or not, the supplier is still required by law to "do the paperwork" and bill Medicare. To keep your cost to a minimum, ask the supplier if it accepts Medicare assignment.

You Must Pay Medicare Copayments

After you have met your deductible, you're still responsible for paying directly, or through supplemental insurance, at least 20 percent of the Medicare approved amount. This copayment may not be dropped by the supplier except in very special hardship situations and only on a case-by-case basis. A supplier who routinely drops the copayment may be violating federal law.

Offers by suppliers to drop copayments or deductibles or to give discounts, coupons, rebates, or other "special offers" -- eliminating the need for copayments on Medicare-approved items -- are illegal. Report such offers to your Medicare carrier.

Special "offers" may seem like a good idea at the time because they appear to be saving you money. But such practices lead to increases in your Medicare Part B premiums and deductibles and unwarranted increased costs to the Medicare program.

Reputable suppliers do not resort to these kinds of incentives. They will provide a reliable product at a reasonable cost to you and the Medicare program.

As the consumer of home medical equipment, you should let Medicare know if you believe a supplier is violating the law. Contact your Medicare carrier. Tell the carrier that the supplier is offering equipment at no cost to you or that they are dropping Medicare copayments and deductibles.

Avoid purchasing equipment from suppliers that:

• Do not have local service and maintenance offices. You'll also have an easier time getting service from a local supplier or get the help if you are unhappy with the equipment or service. You'll eliminate the need for long-distance calls if you're unhappy with the equipment or service.

• Use high-pressure sales tactics to sell their merchandise and who pretend to know what you need. Remember your personal physician knows best your medical equipment needs.

• Offer equipment to you at no charge.

• Present themselves as representatives of Medicare; who for example, tell you that Medicare wants you to have this or that. Medicare does not solicit by telephone or mail, nor does it authorize anyone to do so. Medicare does not supply equipment, recommend specific suppliers, or provide beneficiary names to suppliers.

• Send literature having Medicare emblems and symbols, leading you to believe a product or service is Medicare approved. Medicare does not advertise or endorse particular brands, products, or companies.

You Can Buy or Rent Medical Equipment

You can rent equipment for 15 months. You can rent many items, such as wheelchairs, and hospital beds.

Medicare pays rental for no more than 15 months. (The supplier wilI still rent the equipment to you for as long as your doctor says you need it.)

Suppliers who have received 10 months of rental payments from Medicare must offer you the option to buy the equipment. If you decide to purchase the item, the supplier must transfer title for the item to you following the 13th rental month. The decision to buy the equipment changes the rental payments to installment payments.

Remember, if you decide to continue renting the equipment, Medicare will stop paying for the equipment following the 15th month, except for service and maintenance.

The Centers for Medicare & Medicaid Services administers the federal Medicare program. For more information, visit http://www.medicare.gov.