The Medicare Equipment Is Already in the House. Who Owns It, Who Repairs It, and Who Keeps Billing?

The hospital bed, wheelchair, lift, or breathing equipment is already in the house. Now you need to know who owns it, who must fix it, and whether another monthly claim should appear. Do not start with the equipment label. Start with the claim.

Local option: New Plan Care gives families in the St. Louis area in-home help so a parent can stay home: companionship, help with bathing and dressing, meals, and overnight care. Call (314) 405-0887.

Medicare pays for different equipment in different ways. An item may be purchased, rented, or rented until ownership transfers. Oxygen equipment follows separate rules. A Medicare Advantage plan may use its own network and authorization process. Your first job is to identify the payment track for this exact item.

Who pays

Pull the Medicare Summary Notice, the Medicare Advantage explanation of benefits, or the claim in the secure Medicare account. Write down the supplier name, service date, claim status, item description, and HCPCS billing code. The HCPCS code matters because two pieces of equipment that look similar can follow different payment rules.

Call the supplier's billing office and ask: "Is this item a purchase, a rental, or a capped rental? Who owns it today? What HCPCS code are you billing? How many rental months have been billed? Does your company accept Medicare assignment for every remaining rental month?" Ask the representative to send the answers in writing.

Original Medicare Part B can cover medically necessary durable medical equipment ordered for use in the home when the prescriber and supplier meet Medicare requirements. Medicare says some items are bought, some are rented, and some become the beneficiary's property after the required rental payments. Assignment determines whether the supplier agrees to use the Medicare-approved amount when calculating what you owe. Do not accept "Medicare covers it" as a complete answer. Confirm the claim status and assignment for the actual billing code. See the Medicare durable medical equipment coverage guidance listed on the Sources page.

If the person has Medicare Advantage, call the plan before changing suppliers or approving a repair. Ask whether the item remains authorized, whether the current supplier is in network, whether repairs require prior authorization, and whether a replacement would start a new authorization. The plan's member services number is on the insurance card. Ask for the call reference number.

The papers

Make one equipment file. Put the order or prescription first, followed by the delivery ticket, rental or purchase agreement, warranty, setup instructions, supplier contact sheet, Medicare Summary Notices or plan explanations of benefits, and every repair record. Photograph the equipment label showing the manufacturer, model, and serial number.

The delivery ticket should identify what entered the house. Compare it with the claim. If the ticket says one model and the label or claim shows another, call the supplier before signing any corrected document. Do not sign a statement saying equipment was received, working, or explained if that is not what happened.

Keep these Medicare forms in view:

CMS-R-131, Advance Beneficiary Notice of Noncoverage. An Original Medicare supplier may present this notice when it expects Medicare may not pay for an item or service. Read the item, reason, estimated cost, and option selected before signing. A blank form or a general statement that "Medicare might not pay" does not tell you which charge you are accepting. Call Medicare if you cannot connect the notice to the ordered item.

CMS-10106, Authorization to Disclose Personal Health Information. Use this if the beneficiary wants Medicare to discuss claims with you. This permission does not make you the owner of the equipment, the account holder, or personally responsible for the bill.

CMS-1490S, Patient Request for Medical Payment. Medicare-enrolled suppliers generally submit equipment claims. If someone tells you to file the supplier's claim yourself, call Medicare before using this form. Ask why the supplier did not submit it and what supporting documents Medicare requires.

A signature acknowledging delivery is not automatically a promise to pay every charge. Still, read the signature block. Cross out inaccurate statements before signing and request a complete copy. If the contract names you as guarantor or responsible party, stop and ask the supplier to explain why. Questions about whether a contract makes you personally liable belong with a lawyer, not the billing clerk and not this desk.

The runway

For rented equipment, Medicare guidance places repair and replacement-part responsibility on the supplier. The supplier should arrange pickup if rented equipment needs repair. CMS supplier standards also require suppliers to honor applicable warranties and not charge the beneficiary or Medicare for repairs covered by a warranty.

Call the service department, not only billing. Ask for the regular-hours repair number, after-hours number, emergency coverage procedure, expected response process, and instructions for obtaining backup equipment. CMS quality standards require suppliers to provide contact information for customer service, after-hours access, repair, and emergency coverage.

Use a maintenance log with five columns: equipment, owner, supplier, problem reported, and resolution. Add the serial number and every call reference number. If the supplier replaces the item, record whether it is a temporary loaner, a warranty replacement, or a new rental. Those labels can produce different claims.

Report a move, hospital admission, nursing facility stay, insurance change, prescriber change, or new phone number to the supplier. Medicare's equipment guidance identifies these changes as information the supplier may need. Do not assume the hospital, facility, or insurer notified it.

If the item is owned, ask whether Medicare covers the proposed repair or replacement part, whether a new order is required, whether the supplier accepts assignment, and what HCPCS code will be submitted. Ask for the Medicare-approved amount and your expected responsibility by phone after the supplier verifies the code. Do not rely on a website price or a verbal retail quote.

If equipment is lost, stolen, damaged beyond repair, or no longer usable, do not buy a replacement first and ask about coverage later. Call Medicare or the Medicare Advantage plan. Then call the prescriber's office to learn whether updated documentation or a new order is required. The physician or other authorized practitioner decides what equipment is medically appropriate. This guide stops at that clinical decision.

Review every later claim against your log. Flag rental claims after pickup, duplicate codes for one item, repairs charged during a rental, warranty work billed to you, and claims from a supplier you do not recognize. Call the supplier first and request a corrected claim when the facts are wrong. If Medicare denies coverage, the Medicare Summary Notice explains the appeal route and deadline. A Medicare Advantage plan sends its own denial and appeal instructions.

Free help

Call Medicare for the payment category, processed claims, assignment questions, and the correct appeal path. Have the Medicare number, supplier name, service date, and HCPCS code in front of you. Ask the representative to distinguish what Medicare paid from what the supplier says you owe.

Missouri SHIP provides free Medicare counseling and can help you read a Medicare Summary Notice, understand an equipment claim, and prepare questions for the supplier or plan. Aging Ahead can help connect an eligible St. Louis area household with local aging and caregiver resources. Contact routes for both are collected on Local Help With Paying for Care.

If the dispute is about a Medicare coverage decision, follow the appeal instructions on the notice. If it is about a contract, guaranty, collection demand, or personal liability, take the signed papers and billing history to a lawyer or a Missouri Bar referral resource. If it is about whether the equipment still fits the person's medical needs, take the question to the prescriber. Those are three different problems. Keep them in three different lanes.