Some Medicare managed plans do not cover wound supplies?

  1. 0 Received a message from my office today saying that Humana managed medicare plans will no longer cover some wound care supplies, such as wound cleanser, skin prep, etc.

    Is this something new? Evidently a medical supply company rep told our office this.

    As far as I knew, wound care supplies were supposed to be provided by the home health agency providing care for Medicare patients and thought this would roll over to the Medicare Managed plans, such as Humana, Peoples, etc.

    Our office is going to tell patients they will have to pay for certain wound care supplies out of pocket!

    Anyone with the 411 on this? Thanks
  2. Visit  Isabelle49 profile page

    About Isabelle49

    From 'baton rouge, la'; 65 Years Old; Joined Jun '02; Posts: 811; Likes: 812.

    4 Comments so far...

  3. Visit  KittyLovinRN profile page
    0
    We have Medicare HMO plans that won't cover skin prep too. What baffles me is that no plan around here covers the cotton tipped applicators we use to pack wounds!!!

    Sent from my iPhone using allnurses.com
  4. Visit  Isabelle49 profile page
    0
    Not long ago, very recently, all wound care supplies were provided by the home health agency and the cost for those supplies was to be covered in the lump sum payment. If patients are going to have pay out of pocket for the supply/ies, they should have the right to locate and purchase for a fair price and not be required to purchase from whatever supply company is using. If they were required to purchase from a particular supply company I would think that would cause a conflict of interest or monopolizing situation!
  5. Visit  amoLucia profile page
    1
    I don't do home health, but I see a big potential problem down the road. Pts who are sloooow to buy/replace supplies as needed (like not to run out). Who will then be providing????
    Isabelle49 likes this.
  6. Visit  AMN74 profile page
    0
    This is nothing new for the home health agency that I work for. When we get a wound patient that has insurance that will not provide wound care supplies...first of all, as the agency we always supply BASIC wound care supplies, that is, NS, Tape, Gloves and Gauze. If the patient needs a specialty item it is our agency's policy to provide them with a 5 day supply of the item and also a catelog for a company that will supply their wound care supplies and bill them to their insurance, OR they can go to a local DME store and buy their supplies out of pocket.


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