Medicare-assigned suppliers have agreed to charge the Medicare-approved amount for their products.
Q. How can I find a Medicare-assigned store to purchase an upright walker?
A. To find a Medicare-approved durable medical equipment supplier in your area, you can visit Medicare.gov’s supplier directory. You’ll need to input your zip code, after which the tool will generate a list of product categories. From there, you can select the category that applies to you – in this case, walkers, which is its own category – for a list of retailers in your vicinity.
The database of Medicare-assigned retailers is collected by the Centers for Medicare & Medicaid Services from the National Supplier Clearinghouse (NSC), which is responsible for ensuring that suppliers comply with Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) standards. Suppliers must apply to be included in the NSC as Medicare-approved retailers.
All suppliers must have a Medicare supplier number. Without this number, Medicare won’t pay your claim – even if the equipment in question is something you’re eligible for.
Suppliers that are included in the NSC agree to charge the Medicare-approved price for their products, and cannot bill you for anything more than your Medicare deductible and coinsurance. Furthermore, approved suppliers will generally submit Medicare claims on your behalf.
As a Medicare enrollee, you’re entitled to coverage for durable medical equipment – including walkers – provided they’re prescribed by your doctor. Depending on the circumstances, Medicare’s coverage may allow you to buy the walker, or it may have you rent the walker.
If you’re enrolled in Original Medicare, your out-of-pocket cost for a walker will generally be the Part B deductible (assuming you haven’t already met it for the year; in 2021, it’s $203), plus 20% of the rest of the Medicare-approved amount of the device you need. If you have a Medigap plan, it will cover some or all of that 20% coinsurance (and if you have Medigap plan C or F, it will also pay the Part B deductible; note that Plans C and F are no longer available to newly eligible Medicare beneficiaries).
If you’re enrolled in Medicare Advantage, your health plan will let you know the cost-sharing that applies for durable medical equipment, including walkers. The specifics will vary from one plan to another, as Medicare Advantage plans set their own cost-sharing, within general parameters laid out by the federal government.
Jesse Migneault is a journalist and editor who has written about business, government and healthcare – including public and private-payer health insurance. His articles have appeared in HealthPayerIntelligence, the Hartford Courant, Portsmouth Herald, Seacoastonline.com, Foster’s Daily Democrat, and York County Coast Star.
In addition, his work has been cited by health industry stakeholders such as the Eugene S. Farley Health Policy Center, Association of Healthcare Journalists, American Academy of Actuaries, Kaiser Permanente, blueEHR, San Diego Law Review, Medicare Agent News, healthjournalism.org, and Concierge Medicine among others.