Assignment means that the supplier agrees to accept the Medicare-approved amount as payment in full. If you buy equipment from a supplier who does not take assignment, Medicare will still pay only 80 percent of the Medicare-approved amount. You are responsible for the difference between what Medicare pays and what the supplier charges.

Whether the supplier takes assignment or not, the supplier is still required by law to bill Medicare. To keep your cost to a minimum, ask the supplier if it accepts Medicare assignment.

Medicare Does Not Cover All Medical Products

The Social Security Act that established Medicare specifically extended coverage only to those items that meet the definition of Durable Medical Equipment. Part of that definition included the requirement that it “can withstand repeated use; i.e., be rented and used by successive patients.” Elastic compression garments do not meet this requirement and are therefore deemed a “non-covered item” by Medicare. Medicare does not offer a benefit for elastic compression garments (Compression stockings or ARM sleeves), specialty compression garments (such as JoVi Paks, CircAids or Reid Sleeves), or non-elastic compression garments. (See the Useful Links side bar for Medicare Coverage Database - Indications and Limitations of Coverage (see “elastic stockings”)

However, a recent exception has been made for elastic compression knee-high stockings, but they are only covered for the treatment of venous stasis ulcers secondary to venous disease. (See the Useful Links side bar for Coverage Criteria for Elastic Knee High Garments

You Must Pay Medicare Copayments

After you have met your deductible, you're still responsible for paying directly, or through supplemental insurance, at least 20 percent of the Medicare approved amount. This copayment may not be dropped by the supplier except in very special hardship situations and only on a case-by-case basis.

Offers by suppliers to drop copayments or deductibles or to give discounts, coupons, rebates, or other "special offers" -- eliminating the need for copayments on Medicare-approved items -- are illegal. Report such offers to your Medicare carrier.

Special "offers" may seem like a good idea at the time because they appear to be saving you money. But such practices lead to increases in your Medicare Part B premiums and deductibles and unwarranted increased costs to the Medicare program.

Reputable suppliers do not resort to these kinds of incentives. They will provide a reliable product at a reasonable cost to you and the Medicare program.