Find tips, tricks and information to help you along the way.

02.20.20

Medical Supplies Coverage for Medicare, Arkansas Medicaid, and ObamaCare



Your health is important to you, but getting the medical supplies you need may be frustrating if you have government insurance. You may not know the differences between Medicare, Arkansas Medicaid, or Obamacare plans. And you may not know how to get them to cover your medical supplies.

We understand that the process can be confusing for anyone. That’s why Finnegan Health Services has made this simple guide to tell you what the three government insurance plans cover and how to qualify for them. Finnegan Health Services is one of the largest medical supply companies in Arkansas. We have helped patients get the medical supplies they’ve needed since 1984.

How Medicare Covers Medical Supply Costs

We realize that medical supplies can vastly improve the quality of patients who stay in their homes. These devices help people live independent, happy, and productive lives. Finnegan Health realizes that patients value their health, but medical supplies can be pricey.

Do you need help paying for medical supplies? The federal government has a few programs that can help. One option you can consider is the  Original Medicare program (Part B). It can cover the cost of medical devices you need to survive.

Medicare is a national insurance health program in the U.S. that helps seniors. It began in 1966 under the Social Security Administration. The Centers for Medicare and Medicaid Services now manages it.

The federal government limits which medical supplies it covers under Medicare Part B benefits (doctor and outpatient services). It only pays for items that fall under its Durable Medical Equipment (DME) category.

Medicaid defines DMEs as:

  • Durable devices (lasting three or more years)
  • Equipment that has a defined medical purpose (for a health-related issue)
  • Medical items used for in-home use
  • Supplies that aren’t useful for a person who isn’t injured or ill.

If you’re a Medicare recipient, your benefits may pay for your supplies if they meet the requirements above. You’ll only need to take a few extra steps to get coverage.

First, you’ll need to schedule an appointment with a Medicare-approved doctor that can write a prescription for your supplies. Next, you must have your medical expenses approved by Medicare. Finally, order your DME from a Medicare-approved supplier, like Finnegan Health Services. 

You can trust our company to deliver supplies to your home quickly. We’ve been helping Arkansas residents with their medical needs since 1984. 

Here are a few medical supplies that qualify as DMEs: 

  • Hospital beds, patient lifts, and bedside-commode chairs
  • Oxygen, nebulizers, nebulizer medications, and supplies
  • Infusion pumps and supplies
  • Continuous positive airway pressure (CPAP) machines and supplies
  • Blood glucose monitors and test strips
  • Crutches, canes, walkers, scooters, and specific wheelchairs
  • Suction pumps
  • Lancet devices and lancets

You may ask if Medicare counts prescription drugs as medical supplies. Unfortunately, they don’t, except under limited circumstances. For example, some nebulizer medications may qualify for coverage.

Medicare Part A and B (Medical Insurance) doesn’t cover medical supplies such as bandages or gauzes that patients use at home. They don’t pay for room humidifiers or other objects not used for medical purposes.

If Finnegan Health Services accepts your assignment, you’ll only pay 20 percent of the Medicare-approved amount, and the Part B Medicare deductible will also apply.

What Arkansas Medicaid and CHIP Covers

Medicaid is government insurance that covers medical fees for low-income people.  Federal agencies and local states run this program. It pays for things Medicare doesn’t cover, such as nursing home and personal care services.  The Children’s Health Insurance Program (CHIP) offers cheaper coverage to kids whose families earn too much money to get Medicaid.

Arkansas Medicaid is an agency that handles the state program. It provides healthcare to low-income adults, seniors, pregnant women, parents, and people with disabilities. Children may enroll in the ARKids First (also called the ARKids B program).

If you or your child belongs to these healthcare programs, you may not know which medical supplies you can buy. We’ll explain.

Unlike Medicare, these medical supplies don’t have to be durable medical equipment (DME) to qualify for coverage. Under Arkansas Medicaid, these healthcare items can be used once, then thrown away.  They define medical equipment as DMEs that last three or more years.

Like Medicare, you’ll still need to schedule an appointment with your primary care physician (PCP). You must have a diagnosed health issue to get medical supplies. After you get a prescription, please send it to the Arkansas Medicaid program. Once you qualify, you’ll receive $130.00 worth of incontinence supplies per month (2 cases) and $250 worth of medical supplies.

Here are some items that Full Arkansas Medicaid will cover:

  • Bath safety items, bedside-commodes, and raised toilet seats
  • AeroChambers and peak-flow meters
  • Prosthetic devices
  • Walkers, canes, and orthotic appliances
  • Diabetic supplies (including gestational)
  • Ostomy and Urinary supplies (catheters, leg, and beside bags)
  • Compression burn garments and wound care supplies
  • Incontinence supplies (diapers, pull-ups, bladder pads for men and women, pads for bed)
  • Food thickeners
  • Tracheostomy supplies
  • Nutritional and tube-feeding supplies (if a child is under 21 years old, Medicaid requires proof of a well-child exam or EPSDT from the child’s PCP. If the patient is 21 years or older, they must be tube fed)

ARKids First will pay $125 of medical supplies per month with a doctor’s prescription. These supplies include:

  • Diabetic Supplies
  • Ostomy Supplies
  • Tracheostomy Supplies
  • Urinary Supplies
  • Food Thickener

ARKids First does not cover non-medical supplies like formula, diapers, or nutritional supplements.  Sometimes, Medicaid will cover the 20 percent copay that Medicare patients must provide after all they pay all of their costs. This Medicaid coverage is Medicaid QMB. The policy does not cover any medical supplies or incontinence products.

Medicaid will only pay for specific DMEs for individuals who are 21 years or older. To qualify for coverage, you must obtain a prescription from your PCP.  Arkansas residents that have TERFA, SSI, or “pending” Medicaid should contact us at our toll-free number at 1-888-789-6600 to see if you qualify for medical supplies or adult diapers.

What Medical Supplies Does Obamacare Cover?

In 2010, the U.S. Congress passed the Patient Protection and Affordable Care Act to provide healthcare insurance to 24 million uninsured people. This act is also known as the Affordable Care Act, or Obamacare.

The bill’s goal was to make insurance cheaper for Americans, especially those with pre-existing conditions. The law also gave Medicaid coverage to another 12 million Americans.

Under Obamacare, only durable medical equipment (DME) qualifies for coverage. It falls under the Medicare Part B category (Doctor and Outpatient Services). The ACA will pay for the following medical devices for patients:

  • Blood sugar monitors and glucose testing strips
  • Hospital beds, patient lifts, and beside-commode chairs
  • Oxygen, nebulizers, nebulizer medications, and supplies
  • Infusion pumps and supplies
  • Continuous positive airwave pressure (CPAP) machines and supplies
  • Crutches, canes, walkers, scooters, and specific wheelchairs
  • Suction pumps
  • Lancet devices and lancets

In the past, ObamaCare had a tax of 2.3 percent on manufacturers that made medical devices. It went into effect in 2013. The House repealed the tax in 2017.

Trust Finnegan Health Services for Your Medical Supply Needs

Are you an Arkansas resident searching for medical supplies for in-home use? You can trust Finnegan Health Services to fulfill your medical supply needs. Our family-owned company is one of the most trusted Durable Medical Equipment (DME) companies in Arkansas. We’ll always treat you with respect when you purchase supplies from us. That’s the Finnegan way. Contact us today for more information.

Sources

Nick Cheek

nick

"My Finnegan rep was very sincere in providing me with help for my mom. He stayed on the phone until the job was done. Very good job."

Patient Cave City, AR Patient Cave City, AR

"Very helpful. Even showed me a way to get the items cheaper. Delivery was quick, too."

Patient Sherwood, AR Patient Sherwood, AR

"My Grammy loves her new walker skis! She was so excited to throw away the old tennis balls she had. Thank you!"

Family Caregiver Little Rock, AR Family Caregiver Little Rock, AR