Patients may be unsure on how to receive equipment they qualify for because the insurance and coverage process can be confusing. At Feroz Medical, we guide patients and providers through the entire process — from verification to delivery — with expertise you can count on.
Insurance coverage for durable medical equipment depends on several key factors. Here's what insurers look at — and how we make sure each requirement is met.
Insurance providers require that equipment be medically necessary — meaning a physician must determine that it is essential for a patient's mobility, safety, or daily living, not simply for convenience. Our team works closely with the referring physician to ensure the right documentation is in place from the start.
A written prescription from a licensed physician is required by most insurance plans, especially Medicare. In most cases, a face-to-face clinical evaluation or additional supporting documentation may also be required. Our team communicates directly with the referring physician and their office to ensure all required documentation is gathered and submitted correctly.
Every insurance plan has its own coverage guidelines — including which equipment is eligible, how often it can be replaced or upgraded, and what documentation is required. Many plans also require prior authorization before equipment can be provided. Our team manages the entire process, coordinating with the referring physician and insurer, preparing all required documentation, and following up to ensure nothing is missed.
As a Medicare-approved DME supplier serving Los Angeles and Southern California since 2002, we have extensive experience navigating Medicare Part B guidelines for covered mobility equipment such as wheelchairs, mobility aids, orthopedic braces, and diabetic footwear. With over two decades of working within Medicare's framework, our team understands exactly what's required .
For patients covered by both Medicare and Medi-Cal, we coordinate between both programs to maximize coverage. We work with many of the most common secondary plans in Los Angeles and Southern California — including L.A. Care Health Plan, Molina Healthcare, Blue Shield Promise, and more — to ensure patients receive the full benefits they're entitled to.
We work with a wide range of private PPO insurance providers. Our team verifies your benefits upfront, handles prior authorization, and coordinates directly with your insurer so you don't have to.
We make the insurance and coverage process as straightforward as possible for patients, families, and referring providers. Here's how it works from start to finish:
We receive the patient's written prescription, face-to-face evaluation notes, and all other supporting clinical and insurance documentation, working closely with the patient and referring physician's office to ensure everything is in order from the start.
Our experienced team verifies eligibility, confirms what equipment they qualify for, and identifies any deductibles or co-pays that may apply — ensuring a clear picture of coverage before anything moves forward.
Most plans require prior authorization before equipment can be approved. We work directly with the referring physician and insurance provider to ensure all required documentation is complete, accurate, and submitted on time.
We check the status of every submission and keep the patient informed every step of the way. If a claim is denied, we identify the issue, coordinate with the patient's physician's office to gather the correct documentation, and manage the appeals process to secure approval.
Yes. Medicare Part B covers 80% of the approved amount after your deductible is met, and a secondary insurance typically covers the remaining 20%. Medicare covers one wheelchair every five years. For most of our Medicare patients, especially those with both primary and secondary coverage, equipment is fully covered no out-of-pocket cost.
To keep things moving as efficiently as possible, we'll need basic demographic information, a physician's prescription, face-to-face evaluation notes, and primary and secondary insurance information. For Medicare patients, their Medicare Beneficiary Identifier (MBI) number is required for us to check their eligibility before the process moves forward.
Medical necessity means a licensed physician has determined that the requested equipment is clinically required to treat a patient's condition — not simply for comfort or convenience. Insurance providers, including Medicare, use this as the primary basis for approving DME coverage. Our team works closely with referring physicians to ensure all documentation accurately supports the patient's case before anything is submitted.
Yes, and it's common among our patients. Known as Medi-Medi, this combination typically has Medicare covering 80% and Medi-Cal covering the remaining 20%, with most patients having little to no out-of-pocket cost for their equipment.
Reach out to us for any insurance-related questions or any other concerns you may have, we're always happy to help.
