This post is by no means a comprehensive list of policies, products covered orthe amounts that insurances pay. As a matter of fact the rules and policies of insurance companies including Medicare keep changing and evolving over time. You should contact your insurance companies for the latest information, just to be sure. Most of the information here hasn't changed in a while so its relatively reliable.
Each insurance company has their own list of items they cover for purchase or even sometimes for rentals. The amounts and products further vary according to the plan or policy the customer has. Here are some things that you should keep in mind when considering billing the insurance for a purchase or rental.
1. Call the insurance company first to confirm that they cover the product.
2. Almost all insurance companies including Medicare will require a precription for the item.
3. In some cases they might need more supporting documentation. Contact the insurance to find out what they might be.
4. If its a temporary condition (like a sprain or surgery) then most insurances might not purchase the item instead they might rent the item for you. Esp workman's compensation.
5. Most insurances take anywhere from 3 - 8 weeks to approve and send payment. So, plan your finances accordingly.
6. Maintain and save your records.
7. Document and remember to record the names or IDs of people you speak with at insurance companies.
Medicare
Medicare is great. They pay 80% of all items and 20% is picked up by the secondary insurance or if none exists then the customer. Medicare is specific about what they pay for and how much they pay. Some products, Medicare will pay as a purchase but others they will pay rental upto 13 months and after that it belongs to you. If you, by any chance stop using the product before the 13 months are up then you have to return the item back to the provider. On some products they might only pay partially and you might have to pay the rest. Below you will find a list of most commonly billed items.
Lift chairs - I believe they only pay upto $356.19 or somthing close to it towards a purchase of a lift chair.
Power Chair - They are covered, only towards a purchase.
Wheelchair - They are covered. It might also be a rental.
Hospital Bed - They are covered. Also this is a rental for 13 months and then it belongs to you.
Oxygen - They pay upto 36 months i think.
Canes - They are covered.
Crutches - They are covered.
Walkers - They are covered.
Scooters - They are covered.
3 in 1 commodes - They are covered.
Nebulizers - They are covered.
Air Mattresses - They are covered.
Gel Cushions - They are covered.
Gel Mattresses - They are covered.
There are plenty more products. There is a whole book that shows what products they cover, can't list them all here. If you have a particular product you are curious about then you are more than welcome to ask us. Comment or email or call us.
Medicare often requires supporting documents from the doctor's office, so don't be surprised if it takes just a little longer to get your product. Often, the doctor's offices are so busy that it take them a little time to respond to requests. I have had requests fulfilled in less than 5 mins and sometimes it takes upto 5 days (esp in scenarios where the doctor is out of town or only comes in once a week.) Have a little patience. Not much else you can do. A lot of times, if it they are backed up, you can simply pay them a visit and they can take care of it right then.
This is just a brief overview. Hope this helps.
Regards.
A few inside tips and what you should consider before buying health care / home care products. Having worked in the health care industry for over 10 years, i figure its about time i put some experiences and tips online.
Saturday, February 5, 2011
Friday, February 4, 2011
Rent or Buy Health Care Products?
Like most items that you can rent, there are pros and cons to renting or buying health care products. The biggest factor is the ultimate price you end up paying, literally.
First, the circumstances that govern the decision - Small things can have a big impact on your decision once you realize it. Let’s see, i can maybe narrow it down to two scenarios.
Scenario 1:
You are going on vacation and you or someone in your group uses medical equipment. The reason you need the equipment to begin with is for your safety and comfort. You can't really have a good vacation without either of the two. If the equipment is something small that can be put in baggage like a nebulizer or wrist braces then you should be ok. You will, as you should, just bring what you already have at home. Besides, i don't think many stores actually rent braces. Nebulizers on the other hand can be rented. Things you have to worry about are big and hard to take on vacation with you, like scooters, wheelchairs, lift chairs or even oxygen.
On vacations i have a simple rule... if it fits in the luggage bag and you have room then take it with you. The big stuff, you are better off renting from where you will be vacationing. Trust me, by the time you figure in the price of the extra gas to haul the extra weight, the cramped space in the vehicle, moving big bulky equipment like lift chairs into elevators or up the stairs into your room and quite simply the headache that comes with worrying, you will do better just by renting it. Most rentals are delivered and setup for you in your hotel rooms or where ever you are staying.
You can still buy the lift chair, scooter, power chair, concentrator or any of the other medical equipment instead of renting it, provided it can be shipped to your home. At VMS (Volusia Medical Supply, Inc.) you can rent the product and they will deliver it to you where you will be vacationing. VMS will pick it up after you are done with the rental. Then when you get home you will be delivered a brand new unit that you choose and the amount you paid for the rental (only up to the first month, i really doubt most of us can take a vacation longer than a month anyway) will be deducted from the sale price of the new item. You get the best of both deals. It really is like getting a free rental where you are vacationing when you buy the item from VMS for your home... pretty cool! The only catch is that you have to choose the rent-to-own option when you book your rental, otherwise you will lose the deal.
Important Note: If you are flying to your destination then please confirm with your airline as to what you can carry with you both in baggage and/or as a carry on. Most airlines will allow you to take a portable oxygen concentrator as a carry on, but things like wheelchairs, scooters and power chairs are likely heavily restricted. It would be terrible if you took the items to the airport and then were told that you would have to pay and outrageous fee or you simply couldn't take it with you. A terrible way to start a vacation! So, please confirm with your airlines.
I had a customer once that called the airlines and confirmed with them that he will be able to take a lift chair with him in luggage so long as he pays extra. His trip started in Baltimore, where he had loaded the lift chair in his truck and drove to JFK airport in New York. Once he got there, at the ticket counter, he was told that he was mistaken and that even if he paid extra they simply can not transport the lift chair in the baggage hold of the plane for him. The fact that he had spoken to someone that said that he would be able to, meant nothing at the ticket counter. If he took the chair back he would have missed his flight and paid late fees. The airline suggested they could dispose it for him.... AS IF! I believe he finally convinced them to hold the chair there for a few hours while his friend drove down from Baltimore and took the chair back. They flew to Daytona Beach, Florida and ended up renting it from VMS for a week.
Tip: Bring the small stuff, rent the big stuff, and figure out if you want to buy it before you rent it.
Scenario 2:
If you are injured or post-surgery or for any other reason you need the equipment temporarily. In most cases i would recommend renting the item, if it is available for rent. In most cases! There are maybe only two reasons why you would want to buy it.
The first being that you really like the product or if you need to continue using the product indefinitely (according to the doctor's orders).
The second reason boils down to money! How much will you end up spending on it! If you need it simply for a couple of weeks or a month even then you shouldn't have to worry about it. But on the other hand if you are unsure or if its going to be more than a month then you should figure out which is cheaper. Renting is the way to go as long as it is cheaper to continue extending it. But in most cases in my experience renting it for more than 2 to 3 months might simply mean that you could have owned it by adding a little more money.
Let’s use a lift chair for example. If you rent a lift chair you can expect to pay anywhere from $200 - $300. Now if you need it for 3 months you are better off buying a new one. Because good lift chairs start around $800+ to purchase! You see my point now.
Point of Fact: Most insurances pay for the purchase of an item rather than a rental. Precisely, for this reason. If you do plan on purchasing it then VMS can help. They bill most insurance so you don't have to worry about doing all the paperwork yourself.
Finally,
Most Commonly Rented Healthcare Products
Air Mattresses
CPAP Machines
Hospital Beds
Lift chairs
Nebulizers
Oxygen Concentrators
Portable Oxygen Concentrators
Power Chairs / Motorized Wheelchairs
Scooters
Walkers / Rollators (Walkers with brakes, seat and basket)
Wheelchairs / Transport Chairs
Hope this post helps. If you have any questions then please comment or email.
First, the circumstances that govern the decision - Small things can have a big impact on your decision once you realize it. Let’s see, i can maybe narrow it down to two scenarios.
Scenario 1:
You are going on vacation and you or someone in your group uses medical equipment. The reason you need the equipment to begin with is for your safety and comfort. You can't really have a good vacation without either of the two. If the equipment is something small that can be put in baggage like a nebulizer or wrist braces then you should be ok. You will, as you should, just bring what you already have at home. Besides, i don't think many stores actually rent braces. Nebulizers on the other hand can be rented. Things you have to worry about are big and hard to take on vacation with you, like scooters, wheelchairs, lift chairs or even oxygen.
On vacations i have a simple rule... if it fits in the luggage bag and you have room then take it with you. The big stuff, you are better off renting from where you will be vacationing. Trust me, by the time you figure in the price of the extra gas to haul the extra weight, the cramped space in the vehicle, moving big bulky equipment like lift chairs into elevators or up the stairs into your room and quite simply the headache that comes with worrying, you will do better just by renting it. Most rentals are delivered and setup for you in your hotel rooms or where ever you are staying.
You can still buy the lift chair, scooter, power chair, concentrator or any of the other medical equipment instead of renting it, provided it can be shipped to your home. At VMS (Volusia Medical Supply, Inc.) you can rent the product and they will deliver it to you where you will be vacationing. VMS will pick it up after you are done with the rental. Then when you get home you will be delivered a brand new unit that you choose and the amount you paid for the rental (only up to the first month, i really doubt most of us can take a vacation longer than a month anyway) will be deducted from the sale price of the new item. You get the best of both deals. It really is like getting a free rental where you are vacationing when you buy the item from VMS for your home... pretty cool! The only catch is that you have to choose the rent-to-own option when you book your rental, otherwise you will lose the deal.
Important Note: If you are flying to your destination then please confirm with your airline as to what you can carry with you both in baggage and/or as a carry on. Most airlines will allow you to take a portable oxygen concentrator as a carry on, but things like wheelchairs, scooters and power chairs are likely heavily restricted. It would be terrible if you took the items to the airport and then were told that you would have to pay and outrageous fee or you simply couldn't take it with you. A terrible way to start a vacation! So, please confirm with your airlines.
I had a customer once that called the airlines and confirmed with them that he will be able to take a lift chair with him in luggage so long as he pays extra. His trip started in Baltimore, where he had loaded the lift chair in his truck and drove to JFK airport in New York. Once he got there, at the ticket counter, he was told that he was mistaken and that even if he paid extra they simply can not transport the lift chair in the baggage hold of the plane for him. The fact that he had spoken to someone that said that he would be able to, meant nothing at the ticket counter. If he took the chair back he would have missed his flight and paid late fees. The airline suggested they could dispose it for him.... AS IF! I believe he finally convinced them to hold the chair there for a few hours while his friend drove down from Baltimore and took the chair back. They flew to Daytona Beach, Florida and ended up renting it from VMS for a week.
Tip: Bring the small stuff, rent the big stuff, and figure out if you want to buy it before you rent it.
Scenario 2:
If you are injured or post-surgery or for any other reason you need the equipment temporarily. In most cases i would recommend renting the item, if it is available for rent. In most cases! There are maybe only two reasons why you would want to buy it.
The first being that you really like the product or if you need to continue using the product indefinitely (according to the doctor's orders).
The second reason boils down to money! How much will you end up spending on it! If you need it simply for a couple of weeks or a month even then you shouldn't have to worry about it. But on the other hand if you are unsure or if its going to be more than a month then you should figure out which is cheaper. Renting is the way to go as long as it is cheaper to continue extending it. But in most cases in my experience renting it for more than 2 to 3 months might simply mean that you could have owned it by adding a little more money.
Let’s use a lift chair for example. If you rent a lift chair you can expect to pay anywhere from $200 - $300. Now if you need it for 3 months you are better off buying a new one. Because good lift chairs start around $800+ to purchase! You see my point now.
Point of Fact: Most insurances pay for the purchase of an item rather than a rental. Precisely, for this reason. If you do plan on purchasing it then VMS can help. They bill most insurance so you don't have to worry about doing all the paperwork yourself.
Finally,
Most Commonly Rented Healthcare Products
Air Mattresses
CPAP Machines
Hospital Beds
Lift chairs
Nebulizers
Oxygen Concentrators
Portable Oxygen Concentrators
Power Chairs / Motorized Wheelchairs
Scooters
Walkers / Rollators (Walkers with brakes, seat and basket)
Wheelchairs / Transport Chairs
Hope this post helps. If you have any questions then please comment or email.
How to buy / rent the right lift chair?
Lift Chair: A recliner electronically controlled by a hand piece that also lifts the user to a standing position. Unlike a regular recliner or lazyboy, the chair can be set in any position between a full recline to a full lift position. No more choosing between reclining or not reclining anymore. You can decide what degree of recline or lift you want the chair to be set.
Sometimes, more often than not, people buy health care products online, including lift chairs. Volusia Medical Supply, Inc. (VMS) gets a lot of clients that would rather place an order from the comfort of their home and have the lift chairs delivered. This article is a culmination of our experience in the industry. It should give you a very good idea of what to expect and how to determine the right lift chair for your needs.
A lot of our customers rent the item first and the later on purchase it, if they like it. They are able to rent it, use it like normal and if that’s what they want, then in most cases they can even have their first rental payment applied towards the purchase of a new chair! If possible and available, you might even be able to rent one model for a period and rent out another model before you decide which one you like before you purchase it.
Hopefully the rest of this article will give you some insight into how you can make the best decision in the most handicap of circumstances... i.e. shopping online!
I personally like Pride Lift Chairs so i will use them as the subject chair the rest of the article. Besides the specifics everything else should work for any other brand.
First you will have to figure out what you want from the chair. They come in different sizes, shapes, different types of cushioning, color, weight capacity and finally how far it reclines.
Weight Capacity
Chairs do have a weight capacity. It is what determines the safety and durability of the chair. Most standard chairs have a weight capacity. Most of Pride chairs are rated for users of or under 375 lbs, although they have a couple of chairs with lower capacities at around 250 lbs. This section is simple, if you weight more than 375 lbs then please don't buy a chair or rent a chair that is rated for users of or under 375 lbs. If you don't get a chair that is rated for your weight then you might break the chair (waste of money), it might not be powerful enough to lift you or support you and most importantly you might hurt yourself (this should be your primary concern to begin with!).
Reclining Position
Once you have the weight capacity determined you should probably figure out how far you want it to recline.
There are three types: 2 - position, 3 - position and infinite.
2 - position reclines the least but it does recline. Frankly, we don't sell that many of them and though i fail to realize the advantage, i am sure someone, somewhere has a need for it. There has to be a reason why they would make it!
3 - Position chairs recline almost all the way. This is something that we sell the most of. They recline enough for you to be able to take a nap while not being completely flat like a bed. When reclined all the way, these chairs will still keep your back at around 20 to 30 degrees from the flat maybe. The most popular one and the one that seems to suit most people in this category is the Pride Casual Line model CL-30.
Infinite Position Lift chairs recline all the way to a flat, bed like, position. This is for someone that really needs to be lying down flat when they recline. I could see some uses for this... people with back surgeries or aching backs and obviously if you get a recliner, might as well get one that reclines all the way right? The drawback here is that these are generally more expensive than the 3 position ones. Not always, but mostly, if you compare with the basic 3 or 2 - position ones.
Now let’s move on to cushioning (back).
Different type of cushioning and padding offer varying comfort levels. And, everyone will have their own taste for comfort. More cushioning, less cushioning, floppy pillows or buttoned back. The pictures of lift chairs will give you a good illustration of how the cushions will be on the back. You should be able to tell the amount of padding by simply looking at the pictures. Now for the types of backs there are: Pillow back, biscuit back, split back, sewn pillow back, shell back, dual pillow back and finally the button back. Yup! They do give you plenty of choices! Besides the comfort it’s more or less a preference of what kind of a design you want.
Leg Room
Well, this is a tough one, to satisfy all customers. Now, myself i like it when i rest my ankles on the edge of the leg rest of the chair and let the heel hang off the chair. It gives me more support that way and it avoids putting all the pressure on my heels. I would recommend sizing your chair so it does the same for you. Some people prefer that their heels rest on the cushion, as they wish. Also when you buy a chair make sure you decide on what kind of leg rests you want. There are a few leg rests that are separate from the seat of the chair, so you will have a minor gap between the seat and the leg rest (really makes no difference to me, personally, its negligible). Then you have chairs that have the leg rest attached to the seat (with fabric and cushion). It’s a preference, whatever you are comfortable with. But keep this low on the priority of criteria. I doubt that you will realize the gap once you get comfortable on the chair. Get everything else right and then see if you can satisfy this preference. But please don’t let this stop you from buying a chair that you are otherwise feeling good about! I have seen way too many customers ignore something important and give this one way too much attention, probably end up buying something that is a little less suited for them.
Shapes and sizes
This is very important. No one has the same kind of body. There are three things to keep in mind, about size, when you buy a lift chair.
1. Height of the back - If the height of the back is more than what you need then there is a high likelihood that your head will be pushed forward when you sit in it. Like those annoying head rests on car seats. If that doesn't bother you then don't worry about the size of the back... the more the better.
2. Width of the seat - There is nothing more uncomfortable than sitting in a chair which is barely fitting you, when it is so narrow that you have to squeeze into it or struggle to get out of it. Equally uncomfortable, contrary to common belief, is sitting in a chair that is too wide for you. In a chair that is too wide your arms can't rest on the armrests in their natural comfortable position. Imagine sitting in a chair where you can only have your hands or wrists resting on the arm rests. Sure, you feel like a king or queen, sitting on a throne. But after a while your joints might start to hurt and next thing you know you will have you arms on the seat next to your hips. My suggestion is get a chair with the seat just wide enough that you have a couple of inches to spare on either side of your hips, you should be able to see the cushion between your legs (thighs), and when you rest your arms on the armrests you should have your whole arm resting on it, meaning from the elbow to your wrist or fingers.
3. Height of the chair - this is different from the height of the back. Here we are talking about how high the seat of the chair is off the ground. The objective here is to satisfy a preference whether you want your feet to touch the ground when you are sitting in it. Some people like to have their feet touch the ground when they are in a chair and some like to scoot into a chair with the back of their feet resting on the cushion instead of the bottom of their feet resting on the ground.
Colors
There are about 40 different colors and fabrics you can buy these chairs in... more colors and fabrics in other brands. Match it with other colors in your room or have it stand out. Check out some of the colors and fabrics by clicking here.
Finally, when this chair is delivered by our technicians to your home. Make sure you tell him which side you want the controller!
Hope this article helps you get the right lift chair for you. If you need any more information or have any other questions just comment on this blog or call VMS at 1-866-956-2025! We will be more than happy to help you and answer your questions.
Happy Hunting!
Regards,
Healthcare Pro
A lot of our customers rent the item first and the later on purchase it, if they like it. They are able to rent it, use it like normal and if that’s what they want, then in most cases they can even have their first rental payment applied towards the purchase of a new chair! If possible and available, you might even be able to rent one model for a period and rent out another model before you decide which one you like before you purchase it.
Hopefully the rest of this article will give you some insight into how you can make the best decision in the most handicap of circumstances... i.e. shopping online!
I personally like Pride Lift Chairs so i will use them as the subject chair the rest of the article. Besides the specifics everything else should work for any other brand.
First you will have to figure out what you want from the chair. They come in different sizes, shapes, different types of cushioning, color, weight capacity and finally how far it reclines.
Weight Capacity
Chairs do have a weight capacity. It is what determines the safety and durability of the chair. Most standard chairs have a weight capacity. Most of Pride chairs are rated for users of or under 375 lbs, although they have a couple of chairs with lower capacities at around 250 lbs. This section is simple, if you weight more than 375 lbs then please don't buy a chair or rent a chair that is rated for users of or under 375 lbs. If you don't get a chair that is rated for your weight then you might break the chair (waste of money), it might not be powerful enough to lift you or support you and most importantly you might hurt yourself (this should be your primary concern to begin with!).
Reclining Position
Once you have the weight capacity determined you should probably figure out how far you want it to recline.
There are three types: 2 - position, 3 - position and infinite.
2 - position reclines the least but it does recline. Frankly, we don't sell that many of them and though i fail to realize the advantage, i am sure someone, somewhere has a need for it. There has to be a reason why they would make it!
3 - Position chairs recline almost all the way. This is something that we sell the most of. They recline enough for you to be able to take a nap while not being completely flat like a bed. When reclined all the way, these chairs will still keep your back at around 20 to 30 degrees from the flat maybe. The most popular one and the one that seems to suit most people in this category is the Pride Casual Line model CL-30.
Infinite Position Lift chairs recline all the way to a flat, bed like, position. This is for someone that really needs to be lying down flat when they recline. I could see some uses for this... people with back surgeries or aching backs and obviously if you get a recliner, might as well get one that reclines all the way right? The drawback here is that these are generally more expensive than the 3 position ones. Not always, but mostly, if you compare with the basic 3 or 2 - position ones.
Now let’s move on to cushioning (back).
Different type of cushioning and padding offer varying comfort levels. And, everyone will have their own taste for comfort. More cushioning, less cushioning, floppy pillows or buttoned back. The pictures of lift chairs will give you a good illustration of how the cushions will be on the back. You should be able to tell the amount of padding by simply looking at the pictures. Now for the types of backs there are: Pillow back, biscuit back, split back, sewn pillow back, shell back, dual pillow back and finally the button back. Yup! They do give you plenty of choices! Besides the comfort it’s more or less a preference of what kind of a design you want.
Leg Room
Well, this is a tough one, to satisfy all customers. Now, myself i like it when i rest my ankles on the edge of the leg rest of the chair and let the heel hang off the chair. It gives me more support that way and it avoids putting all the pressure on my heels. I would recommend sizing your chair so it does the same for you. Some people prefer that their heels rest on the cushion, as they wish. Also when you buy a chair make sure you decide on what kind of leg rests you want. There are a few leg rests that are separate from the seat of the chair, so you will have a minor gap between the seat and the leg rest (really makes no difference to me, personally, its negligible). Then you have chairs that have the leg rest attached to the seat (with fabric and cushion). It’s a preference, whatever you are comfortable with. But keep this low on the priority of criteria. I doubt that you will realize the gap once you get comfortable on the chair. Get everything else right and then see if you can satisfy this preference. But please don’t let this stop you from buying a chair that you are otherwise feeling good about! I have seen way too many customers ignore something important and give this one way too much attention, probably end up buying something that is a little less suited for them.
Shapes and sizes
This is very important. No one has the same kind of body. There are three things to keep in mind, about size, when you buy a lift chair.
1. Height of the back - If the height of the back is more than what you need then there is a high likelihood that your head will be pushed forward when you sit in it. Like those annoying head rests on car seats. If that doesn't bother you then don't worry about the size of the back... the more the better.
2. Width of the seat - There is nothing more uncomfortable than sitting in a chair which is barely fitting you, when it is so narrow that you have to squeeze into it or struggle to get out of it. Equally uncomfortable, contrary to common belief, is sitting in a chair that is too wide for you. In a chair that is too wide your arms can't rest on the armrests in their natural comfortable position. Imagine sitting in a chair where you can only have your hands or wrists resting on the arm rests. Sure, you feel like a king or queen, sitting on a throne. But after a while your joints might start to hurt and next thing you know you will have you arms on the seat next to your hips. My suggestion is get a chair with the seat just wide enough that you have a couple of inches to spare on either side of your hips, you should be able to see the cushion between your legs (thighs), and when you rest your arms on the armrests you should have your whole arm resting on it, meaning from the elbow to your wrist or fingers.
3. Height of the chair - this is different from the height of the back. Here we are talking about how high the seat of the chair is off the ground. The objective here is to satisfy a preference whether you want your feet to touch the ground when you are sitting in it. Some people like to have their feet touch the ground when they are in a chair and some like to scoot into a chair with the back of their feet resting on the cushion instead of the bottom of their feet resting on the ground.
Colors
There are about 40 different colors and fabrics you can buy these chairs in... more colors and fabrics in other brands. Match it with other colors in your room or have it stand out. Check out some of the colors and fabrics by clicking here.
Finally, when this chair is delivered by our technicians to your home. Make sure you tell him which side you want the controller!
Hope this article helps you get the right lift chair for you. If you need any more information or have any other questions just comment on this blog or call VMS at 1-866-956-2025! We will be more than happy to help you and answer your questions.
Happy Hunting!
Regards,
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