What you pay
Through Medicare Competitive Bidding approved amounts are set for each item included in the program. Of this approved amount Medicare will pay 80%. The 20% balance is generally covered by a coinsurance. If you do not have a coinsurance you are responsible for this balance.
The Medicare competitive bidding program was designed to lower costs to both the Medicare system and patients. According to the information released in July of 2010 an average savings of 32% was achieved for Medicare. This reduction is to the approved amount. While you will still be responsible for 20% of the bill, this amount will be significantly less as a result of the program.
If you do not have co-insurance and are unable to pay the 20% portion of your bill you may qualify for a hardship waiver through your provider. These waivers are handled on a case by case basis, and not all providers honor them. You should discuss your portion of the bill with your provider prior to beginning service.
Prior to this program the fees paid to providers were determined by Congress. These fees were supposed to be adjusted annually. However, those adjustments were usually not recognized by the providers has they were used to offset federal budget issues.
Under this new program (Medicare competitive bidding) providers were requested to submit proposals to provide medical equipment Medicare patients. These proposals were used to calculate a new fee schedule based on a competitive market environment.
