Why won’t Medicare pay for my commode?

It’s getting tough out there these days folks. With healthcare “reform” and massive cutbacks in programs insisted on by Medicare, things just aren’t like they used to be. Other insurers are seeing Medicare save by tightening their rules, so most of them are doing the same thing.

We get MANY requests from clients that are just having a difficult time getting to the bathroom “on time” and would like to get some assistance. They don’t “want” to use a bedside commode but they have issues going on where they feel they actually “need” one. Often a physician will agree and write a prescription for such a device. Later the client becomes very disappointed when they find out Medicare won’t pay for it. Why not?????

Medicare has an old rule on the books that they didn’t used to enforce stringently. Now, they do.

  1. The rule states a commode can be covered only if:The patient is bed or room confined (meaning they cannot get out of bed or out of their room without assistance from another person) or

  2. The patient does not have a bathroom on the same floor as their bedroom.

That’s it. If you can move about with a cane, walker or manual wheelchair, Medicare expects you to use that to get to your bathroom. They make no exception for those of us who just cannot there “in time”.

We sell lots of commodes on a private pay basis these days……

Paul

Manager and Owner of Gammie HomeCare

Gammie HomeCare specializes in Home Medical Equipment needs for clients on the islands of Maui and Kauai in Hawaii. In business on Maui since 1986 and Kauai since 1999.