How to Be a Self-Advocate & Get the HME You Need

There’s no getting around it—while home medical equipment (HME) is very necessary for many people, it is far from inexpensive and often unnecessarily difficult to obtain. Are you struggling to get the essential home medical equipment (HME) you need to manage your health at home?

You're not alone.

Navigating complex healthcare systems?
Dealing with insurance denials?
Feeling unheard by medical professionals?

These are just a few hurdles you may face on your journey to acquiring the HME you need to thrive in your daily routine and home environment.

What Are Your Rights as a Patient?

As a patient, you have three primary rights:

Right to information (diagnosis, treatment options, costs)
Right to participate in decisions about your care
Right to appeal insurance decisions

How to Communicate Effectively with Your Doctor

The first step to acquiring any HME is getting a doctor’s prescription for the device. You’ll need to schedule an appointment with your provider to assess your condition and equipment needs.

Clearly document your symptoms and needs: Keep a symptom journal detailing the frequency and severity of your symptoms, along with the impact on your daily life (mobility, breathing, sleep, etc).
Prepare to explain how the specific HME would improve your condition or quality of life: You may need to do a little research into that type of equipment and your specific condition or diagnosis.
Ask for a detailed prescription and letter of medical necessity: These documents are critical for establishing a valid insurance claim.
Be clear, concise, and confident: Articulate your needs to your doctor without being aggressive and second-guessing yourself.
Bring a trusted friend or family member: Recruit someone who can offer support, take notes, and/or just provide an extra set of ears.
Get as many details as possible: Don't hesitate to ask for clarification on medical terms or procedures.
Document everything: Take detailed notes about what was discussed, recommendations made, and any follow-up actions.
Before you leave, confirm your next steps: Ensure you understand what your doctor's office will do (e.g., send prescription, submit paperwork).

How to Navigate Insurance Complexities

Depending on the specific type of HME or DME (durable medical equipment) you require, getting your equipment covered by insurance can be a frustrating, complicated battle.

Here are some tips for success with insurance companies:

Make sure you have a solid understanding of key insurance terms: Common terms you’ll need to understand include deductible, co-pay, co-insurance, out-of-pocket maximum, prior authorization, in-network, and out-of-network.
Figure out what your insurance policy covers: Dive into your policy paperwork and determine what HME is or isn’t covered by your policy.
Keep detailed records and documentation: Hold onto your prescription, letter of medical necessity, test results, and doctor’s notes. Then, any time you speak with your insurance company, take note of the date, time, name of the representative, claim or call reference number, and a summary of your conversation.

Be persistent, polite, and professional : Remain focused and calm even when you get frustrated.
Know what to do if your insurance claim is denied: First, review your policy and contact your insurer so you can try to understand the reason for the denial. You’ll be able to find the step-by-step appeal process in the documentation your insurance company provided you on day one.
Seek outside help if necessary: Contact your state’s insurance department for complaints or assistance with appeals. Consider finding a patient advocate or hiring a healthcare lawyer to represent your interests.

Find Home Medical Equipment Today: Use Our HME Supplier Locator Tool

Looking for quality home medical equipment? We’ve simplified your hunt for you! Use our HME Supplier Locator Tool to connect with medical equipment suppliers in your area who can hook you up with the best equipment for your unique needs.

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