Without a doubt, there is no question that medical and home care products are costly, however, typically your private health insurance or Medicare carrier may cover all or part of the expense. TheDiscountCornerStore.com support staff has put together the following suggestions, which include two easy steps, to help you with your insurance claims.

Step 1 - Initiate the Process We recommend that you take the first step and initiate the process by calling your insurance company or Medicare carrier to determine if you have coverage for Durable Medical Equipment (DME) and Home Care Supplies.

What is Durable Medical Equipment? Durable Medical Equipment (DME) is equipment that is ordered by a doctor or prescribed by a health care provider for use in the home and is primarily or as a matter of course used to serve a medical purpose, for example, to manage a patient's diabetes. In addition, these items must be reusable. Some examples of Durable Medical Equipment (DME) and Home Care Supplies that may be covered by your private health insurance or Medicare carrier might include, but is not limited to the following. Ambulatory Items Back Supports & Braces Diabetic Supplies    (Glucose meters, insulin infusion pumps, etc.) Hot & Cold Therapy Incontinence Products Knee & Ankle Braces Neck & Back Care Orthopedic Products Personal Care Products Support Hose Wound Care Products

Step 2 - Prepare to Make Your Call Before you call your private health insurance or Medicare carrier, we strongly suggest that you ask your doctor if the Durable Medical Equipment (DME) or Home Care Supplies he/she has recommended for your use is an item normally covered by a private health insurance or Medicare plan. In most cases, you will need a prescription and letter of medical necessity written by your doctor to obtain a reimbursement. It is important to understand that since insurance companies may offer many different health insurance plans, it is essential to prepare before calling your insurance company. Get the phone number, which is usually on your insurance card and get ready to ask the following questions. What type of plan did I buy? Am I covered for Durable Medical Equipment (DME) and Home Care Supplies? Do you require pre-authorization for Durable Medical Equipment (DME) and Home Care Supplies? Am I covered for? (Ask specifically whether the item(s) listed on your prescription is covered by your policy). Give the product Name and Code * (See Note -1 below). What is the coverage amount and deductibles, if any? Ask about “Reasonable and Customary Charges” Would you mail me a letter describing my coverage? Where should I send my reimbursement documents? * (See Note -2 below). Reasonable Charges The charge for medical services that refers to the amount approved by the private health insurance or Medicare carrier for payment. Customary Charges Charges which are most often made by a provider for services rendered in a particular geographic area.

Note-1 Insurance companies use codes to describe the Durable Medical Equipment (DME) and Home Care Supplies you are acquiring. Go to the specific product page on TheDiscountCornerStore.com web site and obtain the appropriate HCPCS code** for your equipment as displayed under the product image.

Note-2 The DiscountCornerStore.com will mail you an invoice describing the Durable Medical Equipment (DME) or Home Care Supplies, including the purchase price required for insurance reimbursement. You must send the invoice along with a copy of your prescription and, if required, the medical-necessity-form from your doctor to your private health insurance or Medicare carrier. Following approval, it should be reasonable to expect your reimbursement within 30 days.

** HCPCS Codes Codes mandated by HIPAA (Health Insurance Portability and Accountability Act of 1996) as the official code set for services and supplies and is required by Medicare, Medicaid, and many payers to bill supplies, durable medical equipment, patient transport, injectables and chemotherapy drugs, home services, therapy, and ostomy, eye, hearing, and podiatric care. Courtesy of Centers for Medicare & Medicaid Services

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