What Medicare rules apply when purchasing Lincare products?


Quick Answer

When purchasing Lincare products, the Medicare rules on continuous positive airway pressure, or CPAP, devices and accessories apply. The rules stipulate that Medicare covers a trial period of treating obstructive sleep apnea using CPAP therapy and a longer term if a doctor verifies positive results.

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Full Answer

Lincare CPAP Supplies is a Medicare contracted supplier as of 2015. After the Medicare Part B deductible, the Medicare patient pays 20 percent of the cost of the sleep apnea products that Lincare sells. Medicare covers the cost of rental of a CPAP machine for up to 13 months, and then the patient owns the machine. Additionally, Medicare covers needed replacement supplies such as tubing, filters and masks. Because such accessories become worn and no longer function effectively over time, Medicare rules allow their replacement every three months.

If a Medicare patient switches to Lincare from a supplier who no longer contracts with Medicare due to the competitive bidding program for durable medical equipment, he must restart the 13 month rental period of the sleep apnea equipment. However, the overall cost of the equipment is still lower than if the patient remains with the original supplier because the patient needs to only pay the 20 percent coinsurance and not the full cost of the equipment.

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