Molly Janczyk: Coverage for ostomy supplies
From Molly Janczyk, October 8, 2008
Subject: Ostomy Supplies
I see this concern again on the blog.
From experience: First one must determine if certain supplies are covered by RX plan or Medical plan. Some materials are not covered at all.
If the supplies are Dr. ordered and not covered by RX but are covered by our Medical plan and you are 65 +, Medicare pays 80% of the item after your deductible. STRS pays 80% of the remaining 20% and you are responsible for the remaining 20% of the 20%-generally a few dollars by that time. This is in our materials as STRS is the Supplemental plan to Medicare for us.
If you are not 65, STRS pays 80% on covered medical items and you pay 20% after your deductible up to a max of $1500 out of pocket and $500 deductible. Once we have paid the deduc and out of pocket max per calendar year, STRS pays at 100% for the rest of that year.
Subject: Ostomy Supplies
I see this concern again on the blog.
From experience: First one must determine if certain supplies are covered by RX plan or Medical plan. Some materials are not covered at all.
If the supplies are Dr. ordered and not covered by RX but are covered by our Medical plan and you are 65 +, Medicare pays 80% of the item after your deductible. STRS pays 80% of the remaining 20% and you are responsible for the remaining 20% of the 20%-generally a few dollars by that time. This is in our materials as STRS is the Supplemental plan to Medicare for us.
If you are not 65, STRS pays 80% on covered medical items and you pay 20% after your deductible up to a max of $1500 out of pocket and $500 deductible. Once we have paid the deduc and out of pocket max per calendar year, STRS pays at 100% for the rest of that year.
posted by Kathie Bracy at 10:53 PM
<< Home