What Does Medicare Cover in Wound Supplies?

wound_careMedicare is offered in a variety of forms, so it is important to find the right coverage for yourself, your financial situation and your condition. If you are looking into wound care options, here are a few details to consider:

Dressings

Medicare win cover all surgical dressings that are deemed medically necessary for your treatment. You will only be responsible for the co-payment amount for these dressings (each of which is set for the type of dressing). Dressings are covered under Medicare Part B, and so the standard deductible applies.

Home Care

Medicare Part A can cover the costs for at-home-care that is deemed medically necessary. This can include, but is not limited to: changing and applying sterile dressings to a surgical wound site, the cleaning or washing of the wound site and/or the administering of certain medicines.

Follow-Up Care

Interestingly, Medicare requires that clinicians provide documentation of the presence of a wound to continue treatment and coverage. Medicare does not want to pay for services that are not being used, so it requires evidence that demonstrates a condition. Paperwork that has been completed or at least signed by your clinician that may be required for your wound includes:

  • Evidence of the wound
  • Wound size
  • Wound extent
  • Drainage needs

Overall Costs

If you qualify for coverage, Medicare will cover 80 percent of the approved amount of your costs. W.L. SCHNEIDER ASSOCIATES will bill & collect the remaining 20% for the cost of these supplies. However, all costs that are submitted must be deemed medically necessary to receive this cost breakdown. Costs for other conditions that are submitted, such as additional unrelated ulcer wounds or the like, must be documented by your clinician.

If you are covered under a plan other than Original Medicare, such as a MediGap or Medicare Advantage Plan, get in touch with your plan provider to discuss chronic wound coverage, as the rates may be different.

Things to Consider

Before choosing your clinician, be sure that they accept Medicare. If they are not enrolled, Medicare will not pay the claim. As with most services, you must pay your annual deductible for services and supplies to be delivered; so these costs should be factored into your decision as to what type and level of care is best for you.

Comments are closed.