Sticker Shock: Understanding DME Prices


At New Mobility, we get a lot of questions about why disability equipment costs so much. A significant number of readers think that manufacturers are gouging us and that dealers are just out to make a buck. Surely wheelchair costs needn’t look like line items on a new Ford Mustang, right?

With the current climate of shrinking insurance coverage and narrowing options, we decided to follow the money as far as we could. What we found is that “complex rehab technology” is well-named: The complexity of the equipment is matched, if not surpassed, by the complexity of FDA approval, Medicare reimbursement and qualified customer service in our unique community of producers and consumers. We have also come to believe that the great majority of manufacturers and dealers are our allies. They must make a profit to stay afloat, but when you lift the curtain, you often find engineers thrilled to be designing for independence, company advocates toiling for better Medicare coverage, and technicians working overtime to uphold our quality of life. Here is a peek behind the scenes at a few of the companies who, yes, make a living, but who also make a difference in our living.Here is a glance at price tags on a complex rehab power chair. It’s not Permobil’s top-of-the-line chair, but it does have state-of-the art components for staying healthy as a quad. There are three figures to be aware of: What the retailer charges if you don’t have insurance, how much Medicare reimburses the retailer (80 percent of the “allowable” covered charge), and what, ultimately, the end user is responsible for paying (20 percent of the “allowable” covered charge). Most private insurance companies base their rates on what Medicare covers. What we can’t see is the dealer’s cost, a price negotiated with the manufacturer based on volume of sales. And, as hard as we tried, exact manufacturer costs are nearly impossible to define (see The True Cost of Wheelchairs and Components).

See Also:

A look at some of the “whys” behind wheelchair component costs, including the convoluted Medicare system.

An in-depth view of how changes to Medicare funding are harming one crucial health product — cushions.[fusion_imageframe lightbox=”no” lightbox_image=”” style_type=”none” hover_type=”none” bordercolor=”” bordersize=”0px” borderradius=”0″ stylecolor=”” align=”none” link=”” linktarget=”_self” animation_type=”0″ animation_direction=”down” animation_speed=”0.1″ animation_offset=”” hide_on_mobile=”no” class=”” id=””] [/fusion_imageframe]

R: Retail     M: Medicare Reimbursement     C: Cost to Consumer

1.

F3 Corpus Base
R: $7,295
M: $4,348
C: $1,087

2.

2 Batteries (Group 24)
R: $945
M: $280
C: $70

3.

Seat (with 50 degrees power tilt and 175 degrees power recline to help prevent skin breakdowns)
R: $11,355
M: $6,690
C: $1,673

4.

Corpus Ergo (or Ride Designs) Back
(designed for power recline chairs)
R: $993
M: $376
C: $94

5.

Headrest
(10” with hardware)
R: $369
M: $155
C: $39

6.

Wiring Harness for Expandable Controller
R: $561
M: $274
C: $68

7.

Expandable Controller
(for tilt/recline functions)
R: $635
M: $372
C: $93

8.

Corpus VS Power Elevating Legrest*
R: $3,162
M: $2,400
C: $600

* Medicare is inconsistent in its coverage of this component. In some cases, it may be available only if the consumer pays full price.

The Bottom Line

Total Cost for Permobil F3 Corpus with Power Recline, Tilt and Elevating Leg Rests

Retail: $25,315

Medicare Reimbursement to dealer: $14,894
(80 percent of allowable charge)

Cost to Consumer: $3,724
(20 percent of allowable charge)

Prices quoted are from February 2016 and are subject to change.


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