Medicare supply coverage - General Ostomy

RE: Medicare supply coverage

GoatHerder — Sat, 13 Jul 2024 16:34:50 +0000

@cygo I get the ostomy supplies that I desire through my local supplier. They are prescription, but in Florida where I am, the prescription only needs to be issued once and doesn't require an annual renewal. After trying many different brands and styles, I have been using the Hollister 2 piece convex system for about 10 years now with no complaints.

RE: Medicare supply coverage

LLNorth — Sat, 13 Jul 2024 15:27:22 +0000

I have Medicare and a supplemental insurance. My experience is that my primary care (family practice) doctor has to renew a prescription for ostomy supplies annually and that those supplies and amounts of each are specifically noted - those are the supplies I can get during that year. They are not generic; I have been using the Hollister brand. It would be complicated to get them changed to another brand but not impossible. I have been happy enough with them; they are the same supplies that the ostomy nurse ordered before I left the hospital after my surgery, six years ago.

I have spent very little out of pocket for ostomy supplies. The supplemental insurance is not cheap - however, I appreciate having it.

RE: Medicare supply coverage

cygo — Sat, 13 Jul 2024 14:59:16 +0000

@goatherder

This good news.

Are ostomy supplies considered medical supplies or prescriptions, I’m assuming medical supplies.

Do they let you get the brand you prefer or do use generic brands?

Thank you.

RE: Medicare supply coverage

GoatHerder — Wed, 26 Jun 2024 00:46:43 +0000

Get a Medicare advantage plan if you can. A PPO if at all possible. My monthly ostomy supplies only have a $40 co pay with my Humana PPO Medicare advantage plan.

RE: Medicare supply coverage

VeganOstomy — Tue, 25 Jun 2024 16:04:28 +0000

Hi @rick. Being Canadian, I wouldn't know first hand how Medicare works, however, ostomy supplies seem to be covered in this FAQ:

"Medicare Part B pays for 80% of allowable charges for ostomy supplies after you meet the Medicare Part B deductible."

A lot of other questions are also answered in that page. I hope that helps!

Medicare supply coverage

Rick — Sun, 23 Jun 2024 22:21:13 +0000

I will be signing up soon for Medicare and for those living.in USA, any suggestions on which part of Medicare covers ostomy supplies?

thanks