If you or a loved one has an advanced illness, you probably know that complex inpatient care is often followed by special care at home. You might need a ventilator, feeding tube, or other special medical equipment.
Medicare Part B (medical insurance) may help pay for a broad range of medical equipment and supplies to help you with basic activities while you recover. Part B might cover ventilators and feeding tubes.
What is a ventilator?
According to the National Library of Medicine, ventilators are machines that help you breathe. They can deliver oxygen to your lungs and remove carbon dioxide from your body.
Doctors might prescribe home ventilators for people who have:
- Certain neuromuscular diseases
- Thoracic restrictive diseases
- Chronic respiratory failure resulting from chronic obstructive pulmonary disease (COPD)
That’s according to a Center for Medicare & Medicaid Services manual.
What is a feeding tube?
There are at least two types of feeding tubes, according to the National Library of Medicine,
A gastronomy feeding tube is a surgically placed tube that goes from the outside of your belly into your stomach. A doctor might prescribe a feeding tube if you have trouble swallowing.
Does Medicare cover home ventilators and feeding tubes?
Medicare Part B may cover feeding tubes as part of durable medical equipment (DME). To qualify for Medicare coverage, home ventilators and feeding tubes generally must be:
- Medically necessary
- Prescribed by a doctor
- Not used by anyone who isn’t ill or injured
- Likely to last for three years or more
- Used at home
- Provided by Medicare-enrolled suppliers
Read more about durable medical equipment.
How do I find suppliers of home ventilators and feeding tubes?
If you have traditional Medicare (Part A and Part B), you can find suppliers of ventilators and feeding tubes on Medicare.gov. Medicare’s search tool gives you a list of Medicare-approved DME suppliers.
In some parts of the country, Medicare might only cover DME from suppliers who contract with Medicare through the competitive bidding program. This program is designed to reduce out-of-pocket costs and promote quality of care and services.
Ventilators and feeding tubes: what if I have Medicare Advantage, or Medicare as a secondary payer?
Competitive bidding affects only those people who have Medicare Part B as their primary payer. If you have a Medicare Advantage plan, or employer-based insurance (for example) instead of Part B, you might not be restricted to Medicare-contracted DME suppliers.
If you are enrolled in a Medicare Advantage plan or an employer-based plan, contact your plan’s customer service to verify which suppliers of home ventilators and feeding tubes the plan will cover.
How much will I pay for Medicare-covered ventilators and feeding tubes?
Typically you pay 20% of the Medicare-approved amount for a home ventilator or feeding tube. That’s assuming you use a supplier that Medicare covers.
Curious about Medicare Advantage plans? To get started, simply click the Get Quotes button to schedule a phone call or to request a personalized email.