2013-05-09 / Columns

Making Medicare Make Sense

Answers to some of the most commonly asked questions

Q: What is the new program beginning in July in certain areas across the nation where Medicare beneficiaries will pay less out of pocket for certain medical equipment and supplies if they purchase them through Medicare contract suppliers?

A: Medicare is expanding its competitive bidding program from the current nine to 100 markets across the country as of July 1. The object of the program is to cut costs to both people with Medicare and taxpayers as a whole. Under the current system, Medicare has been overpaying for things like hospital beds, walkers, and oxygen. And too many fraudulent suppliers have gotten into the system. Competitive bidding means that only suppliers who are accredited, licensed, bonded, financially stable, and willing to provide good customer service in these 100 markets will be able to bill Medicare for equipment in several categories. This will affect you if you live in, or travel to, any of these 100 markets.

Another aspect of the program will affect you if you use diabetic testing supplies. The program now offers mail-order service for these products everywhere in the country, at prices much lower than before. That means your co-payment will be lower, too. You can still go to a pharmacy to get these supplies if you want to, but in some cases the savings won’t be as great; check with your pharmacy to see if they are participating.

How the Program Works

If you have Original Medicare, and your permanent residence is in a ZIP code that is part of a Competitive Bid Area (CBA), or if you travel to a CBA, and you use items in one of the program categories, you generally must use a Medicare contract supplier to have Medicare help pay for the item. Lists of contract suppliers are available online at www.medicare.gov, or on the phone at 1-800-MEDICARE (1- 800-633-4227). TTY users can call 1-877-486-2048. There are typically many suppliers in each market from which to choose.

This program really saves people with Medicare, and all taxpayers, a lot of money. In just the first year, in just the first nine markets, the savings were over $200 million. The expanded program is expected to save Medicare more than $25 billion in the next ten years, and people with Medicare are expected to save $17 billion more in reduced out-of-pocket costs and premium payments.

Medicare has found that this program also reduces fraud by checking out all suppliers before they are even allowed to bid, and extensive monitoring of the program since it began in 2011 shows that there is good access to the equipment and supplies you may need, with the same high quality you have every right to expect.

For additional information about the Medicare DMEPOS Competitive Bidding Program, including all of the products and items that are covered under the Competitive Bidding Program, please visit: www.cms.hhs.gov/ DMEPOSCompetitiveBid/.

Remember, this expansion of the competitive bidding program and the national mail-order diabetic supplies program will go into effect July 1, 2013.

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