Often times a great deal of us will need medical equipment, also known as durable medical equipment at some point throughout our life.
The majority of us simply do not want to think about “when we get there”. But what if “we are there” already? What if we need some support during walking, or simply avoid walking long distances because we have less balance.
Here you will find some guides in lieu of assisting you to help you decide whether you need that extra support.
Planned Surgical Procedures
Surgeries such as the orthopedic ones (replacements of: total hip, total knee, total ankle) will definitely require to have medical equipment before you are discharge to your home.
As an example, for both knees and hips replacements you will need a front wheel walker, and a 3:1 commode. Although you will not need these items for a long time, without these, your procedure can be greatly compromise as you need support while you are healing.
In regards ankle replacements, because you will be non-weight bearing in one leg for sometime, you will need a wheelchair for home. Ideally you have a knee scooter, but most of the times you will need to rent one of these.
There are many other surgeries, and procedures that will require medical equipment for the home use. Just talk to your doctor and his team about what items and/or medical equipment will you need to have prior to your surgery.
Nevertheless, keep your medical supplies at least for five years because your insurance will not cover your equipment if it’s been less than five years since you got your equipment.
In addition, if you had an orthopedic procedure due to osteoarthritis, bad news, you might need another joint procedure.
Fall Prevention-How having medical equipment can help
It is good idea to start looking for supplies for your parents, or grandparents, especially when they are reaching an advance age. The older population is at a higher risk of falls, and accidents, that can also compromise their joints.
One very common fracture that we see in the hospitals, is the hip fractures in the older population. Having a walker at home, can not only aide in the fall prevention, but also have your loved ones more active as they can walk more with that little extra support.
The most popular walker that is recommended by our physical therapists is the front wheel walker which is pretty affordable. If you start noticing that your loved ones are starting to avoid walking longer distances, poor balance, and maybe dizziness, consider the purchase of a walker.
What will my health insurance cover?
This question is very broad, and it truly depends on your health insurance, and the specific medical diagnosis for which you want coverage.
Often times, you might get approval, and some other times, for various reasons, you might get a denial. Even sometimes, your copay might be higher than purchasing the item in other sources.
Again, the key is communicating with your health insurance about your coverage so that you can make a decision if you want to purchase a medical supply.
In addition, most health insurances offer reimbursement if you did have coverage, and a qualifying diagnosis. If you are going through your health insurance for coverage, you will need to ask your physician for a written prescription with an “ICD10 Diagnosis Code” for billing purposes.
If your physician does not believe you need the item, it is his medical opinion, you cannot make him write it. Therefore, you will have to purchase the item out-of-pocket if you still feel you need it (no prescription necessary.
Nevertheless, always try to get insurance reimbursement to protect your money and coverage.
Medical Equipment via Insurance vs Out-of-Pocket
Via Health Insurance
In a perfect World, your health insurance takes no time to approve durable medical equipment, and supplies. In the real World, this can be a long waiting, before we hear a “yes” or “nay”.
If your insurance didn’t take long, and promise will deliver your items in a short period, then you better keep your insurance intact.
In addition, when the supplies are more expensive such as oxygen for home, life vest, a hospital bed, a wound vac, etc, is best you wait for your health insurance determination.
If your insurance denies any of these, let the case manager or social worker determine what other steps are necessary, and how can you safely transition to home.
If your health insurance is taking a long time to approve your medical supplies, and you can afford it, (such as a walker, cane, commode, wheelchair); then I encourage you to discuss with your health coverage about their reimbursement options.
In addition, often times your insurance, and for many reasons might deny coverage for your items. But if they were recommended by a health professional, purchasing these out-of-pocket might be a life saving decision.
This is just the Beginning
Whether you choose to purchase your medical equipment, or your insurance covered the item(s); your life will greatly improve by having an assistive device at home.
Owning a home medical equipment might be the beginning of an exciting journey (new knee replacement), with the goal of -eventually- not depending on any medical device.
On the other hand, having medical equipment at home can greatly improve the quality of life for you and even your loved ones. On either case, it can aide on falls prevention, and subsequently safe lives.
If you have any questions, comments, or concerns, feel free to leave a message below, or send me an email at firstname.lastname@example.org, and I will be more than happy to assist you.