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40% of Medicare Beneficiaries Report Having to Pay Out of Pocket for Home Medical Equipment Per Patient Hotline

Home Blog 40% of Medicare Beneficiaries Report Having to Pay Out of Pocket for Home Medical Equipment Per Patient Hotline

When Medicare slashed funding for vital home medical equipment this summer by 50-80%, People for Quality Care saw an uptick in the number of callers having difficulty getting their needed equipment, services, and supplies. This is, in part, due to an increasing number of home medical equipment companies that are now having to file Medicare claims non-assigned, requiring beneficiaries to make up the difference in cost and the amount Medicare is willing to pay. 

“I just a received a letter from my oxygen provider saying that they would not be taking assignment anymore, and I would be required to pay up front for my supplies. I am on a fixed income and don’t have the ability to do so,” said Terrie S. a Medicare beneficiary in Grand Island, Nebraska.

“40% of our calls are from patients and family caregivers who are now being asked to pay out of pocket for their home medical equipment that should be covered by Medicare,” reports Kelly Turner, Director of Advocacy for People for Quality Care.  “Many patients don’t have the financial capacity to take on this additional cost, yet the companies who serve them are operating in the red with Medicare’s current reimbursement.  Both sides are being squeezed.  It’s a no-win system.”

Medicare Funding Shortage Causes Company Changes, Patient Expenses Increase

Companies like Air-Way Medical in ultra-rural Bishop, CA have grave concerns about their ability to continue serving their patients if Medicare continues to severely underpay for the equipment, supplies, and services patients need.  “We’ve done all we can to save money,” laments Glenn Steinke, owner of the 30-year-old company.  “I haven’t taken a paycheck since July.  We’ve had layoffs, discontinued product categories, and are now billing nearly half of our Medicare claims non-assigned.” 

Air-Way Medical is not alone.  Last week, a study came out that showed that nationwide, companies are only being paid 88% of their costs of providing home medical equipment to Medicare beneficiaries, driving many companies to turn to their patients to pay the remaining balance out of pocket. 

While some patients can afford to take on the extra expenses, many cannot, which is further exacerbated in rural areas that are generally poorer than their urban counterparts.

If Companies Exit the Market, Where Will Patients Go?

With a large rural service area spanning 10,000 square miles, Air-Way Medical is the only company with a physical location within 150 miles that can serve Medicare patients.  “If I am forced to go bankrupt, no one else is left to fill this void.”  Medicare beneficiaries are already witnessing the effects in their communities as companies close branches, restrict service areas and stop taking Medicare assignment. 

If Congress doesn’t intervene, companies will stop taking Medicare all together or close, leaving patients with no alternative but to go without, resulting in increased ER visits, hospitalizations, and premature admissions to skilled nursing facilities. 

Immediate legislative action is needed when Congress returns in November to stabilize the home medical equipment benefit and ensure patient access.  Advocate for Medicare beneficiaries’ continued access to home medical equipment by calling the Washington D.C. switchboard at 1-202-224-3121 and sending a letter to your legislator.

Click here to send a letter to Congress about this important issue. 

Help us pass this important story along-  Download the press release below, add your contact information, the date and forward to your local media contacts.

Similar efforts in the last couple of months have been widely successful because your area newspapers, television and radio stations have a vested interest in reporting on community-based issues. 

Press Release: 40% beneficiaries paying out-of-pocket for equipment per hotline



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