The Cellar / Medicare pricing

**Posted by Diaphone Jim** 11/08/2023 12:56 pm

Not sure how many here are Medicare recipients, but I am curious how they set and/or allow costs for devices (often called durable devices).
I got a sore shoulder sling a few months ago that did little good but my copay is $25.
The sling retails for about $15, but the provider billed Medicare for $148, who did their little discount dance, came up with $125, paid them $100, leaving that $25.
The company billing me says that Medicare sets the price (for thousands) of devices and they deserve the 1000% markup.
Sounds like the old $600 AirForce hammer and $?? toilet seat .
The same thing may happen all across the med insurance world.
How to find out the actual process?

**Posted by Clodfobble** 11/08/2023 2:46 pm

Why find out the process, if you can't change it anyway? Obviously it's harder for prescriptions, but for medical devices (like arm slings) you can just go around the system and buy it yourself online.

**Posted by xoxoxoBruce** 11/08/2023 5:41 pm

The problem is Congress (as usual), the law doesn't allow medicare to negotiate drug prices as the suppliers already owned the congress critters.
The problem with the patient is you go to the doctor and he says wear this.
The patient says ok and finds out later the costs, and researches the alternatives.
Unless he's been burned a few times, it probably isn't even in the thought process at the time.
In the doctors office your mind is busy contemplated the impact of what he says about your condition plus trying to think of the other shit you wanted to ask him about that you should have written down but nooo, you'll Shirley remember stuff that important to your life and limb.