Cash pay Vs Upgrade with insurance

June 02, 2015 Aaron Kendrick

While working in the retail setting one of the most common items upgraded was the standard front wheel walker. In most cases this is covered with a minimal $15 to $25 dollar co pay. Many of the patients coming in to get a walker would prefer the 4 Wheel Walker with a seat, basket and brakes. In order to provide the patient with a 4 wheel walker the provider will offer to bill your insurance for the standard front wheel walker, while charging you the patient the remaining retail price including your co pay on the standard walker. To complete this process most Medicare plans require you to complete a quick form which notifies you that your insurance is not going to be billed for the upgraded items on the walker.

Lets take a close look at the numbers

1st: The 4 wheel walker shown above suggested retail price is $335.40, your insurance will be billed roughly $75.00 depending on your plans and coverage, leaving the remaining $260.40 to be paid by the patient.

2nd: The same 4 wheel walker paying 100% out of pocket on, saving you the cost of your doctor visit to get the prescription and time to travel to your local supplier. $151.31 add shipping of $5.95 total charges $157.26. Saving you a total patient out of pocket of $103.14 in this example.

These numbers can and will change depending on the retail price of the walker you choose and your insurance coverage. The important thing to remember is that just because you have healthcare insurance using it is not always going to be the lowest cost option. And you cannot expect a medical equipment provider in a retail setting to inform you to save money by shopping online.


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