Availability

Equipment assistance is NOT guaranteed and depends on availability of funds.

Eligibility

Managed Care is the payor of last resort and will not be responsible for or authorize payment/assist in payment for medical equipment if Tribal Member is eligible for alternate resources. If eligible for alternate resources, that would cover all or part of DME ordered, tribal member must apply for alternate resources.

Services Allowed

• Managed Care covers equipment that insurance would cover/approve. However, there MAY be some equipment, such as shower chairs, pulse ox meters, rotor assist beds, transfer benches, splints, walking boots, braces, and/or compression hose or other items Managed Care MAY approve based upon patient condition and need.
• Managed Care will only cover equipment purchases in the time period allowed by insurance.

Patient Responsibility

• Patients are expected to take care of equipment; any repairs or replacement for any misuse/abuse/neglect will be the patient’s responsibility.
• Patient/family is responsible for returning equipment to supplier or Managed Care after use, if applicable, or patients/family may be responsible for cost of equipment.
• Managed Care follows insurance guidelines in regard to equipment and patient responsibility. If patient is not compliant, per insurance guidelines, equipment will be picked up or patient can pay out of pocket (example- C-pap and Bi-pap machines). In addition, if patient cannot show compliance with equipment, accessories such as masks and tubing will not be purchased by Managed Care.
• If insurance requires any follow up physician visits to continue providing supply, patients must comply with seeing physician or equipment may be picked up and Managed Care will not continue paying for equipment.

Contact Information