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Medicare Preauthorization

Medicare To Require Pre-Approval for Certain Medical Devices

Starting Feb. 28, Medicare will require pre-approval for some of the most commonly used home medical supplies, including oxygen, sleep apnea gear, and related equipment. The change comes as a response to a large amount of system abuse, and hopes to scale back inflated claims.

Savings for Medicare; Concerns for Beneficiaries and Providers

Medicare anticipates that savings from this initiative will save upwards of $10 million over the course of 2016. By 2025, the savings could total $100 million. Medicare claims that these measures will not negatively affect patient care. Providers and beneficiaries, however, are not so sure. Currently there is concern that for certain medical devices, the delay from requesting and receiving preauthorization cold cause negative effects to a patient’s health.

Medicare Advantage Unaffected by the New Policy

It should be noted that only recipients of traditional Medicare will be affected by the new policy. Seniors with Medicare Advantage coverage will not be affected, because those plans contract independently with providers, some of which may already require preauthorization for certain devices. Check with your provider for the full details of your own plan.

For those who are affected, certain hospital beds, power wheelchairs, and oxygen concentrators are among the devices that will require preauthorization from Medicare starting Feb. 28. Requests for approval are anticipated to be answered within 10 days, with the possibility for expedited review within two days for certain cases.


Medicare Plans Washington

If you are nearing or already 65 and would like more information on Medicare Plans in Washington State, please visit our Overview of Medicare, as well as our guide for those who are New to Medicare. For assistance in choosing a Medicare plan, contact us to get in touch with a licensed insurance agent today!

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