Need advice on changing ostomy supplier with Medicare coverage

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Carol N

I've been with Burman Medical since my urostomy in February 2021. I've tried multiple Coloplast pouching systems since, and they've always stocked those. I requested free samples from ConvaTech and a few days ago, discovered one of the samples (a two-piece, with a moldable skin barrier) met my needs better than any of the pouches I tried before. Today I called Burmans to see if they carried these pieces and although they carry the pouch itself, they don't carry the moldable skin barrier. I ordered some off of both eBay and Amazon, but I can't possibly afford to pay for them out of pocket in the future. I'm on Medicare and they pay for all my ostomy supplies now. Has anyone else who's on Medicare changed their supplier? If so, how do you do it? I'm at a loss.

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Call Convatec back and ask them if they can help. I'm sure they get asked about it a lot. You may also need to talk with a Medicare rep to find out if there's another supplier they will cover.

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Beth22

Hi there,

So I have had to change suppliers 3 different times unfortunately.. But what you do is call your insurance company and find out what distributors are in network, call the distributors and ask them if they carry the brand and model you like. If you have the numbers from your samples, even better. Once you find a distributor you want that has your product, put in an order with them. They will send over the authorization to your doctor and then it will be sent out. My best advice is to call them as soon as you can and place an order. Some distributors can take 2-3 weeks and it will also go when your insurance allows your monthly order.

HenryM

I used the same supplier for years but eventually got disgusted with their administrative bungling.  So I just contacted a different company and began ordering from them.  I had to be satisfied with a smaller order than I preferred the first time, since they wanted to be sure I was covered for it.  I'm on Medicare like you; I also have a backup insurer.  Since then, I order what I want with no issues.  Any decent ostomy supply company should carry the major brands.  I use Hollister and get them from Better Health Supplies, Inc.

Audrey Warren
Reply to Anonymous

Edgepark in the US is a very reputable supplier and will work with you.

 
Staying Hydrated with an Ostomy with LeeAnne Hayden | Hollister
Beth22

I mean no offense at all to anyone using Edgepark, but I highly recommend you run far away from them. They did not send out my bags and left me sitting without bags for an entire month. A family member had to go onto medical monks to pay for a month supply of bags for me. They triple charge you and your insurance company for every product you order. No one at all knows what they are doing or talking about. I left them after not getting my bags. Just a heads up, don't want you to go through a nightmare the way I did and again.

Audrey Warren
Reply to Beth22

Who would you recommend? I'm a "newbie" and my healthcare nurses suggested Edgepark.

Beth22

Unfortunately for us, we have to go based on insurance and who they cover unless paying out of pocket. I have been with Comfort Medical when I had a previous health insurance, Edgepark, and Prism right now. By the way, Prism is horrible too. They will not send out the brand you use in adhesive remover wipes, barrier wipes, deodorant, and some other supplies. Prism will only send out Safe N Simple even though they take your order for the brand you put in and say they have it. They only have it if you pay full out of pocket to them, and they will not send it through your insurance. I was left without remover wipes, barrier wipes, and of course, they don't care and can't give an answer as to why they won't send the brand you use. Both Prism and Edgepark are by far the worst.

Beth22

So Audrey, I will say completely avoid those too at all costs and see who else your insurance covers.

Immarsh

I had to change suppliers several times... One supplier went out of business, another didn't carry all the brands I use... I found out several names from Medicare of suppliers who carry the products I use.. My doctor wrote the script.. All I had to do was register, and send supply list to the new company.... They do have to go by the guidelines of what your insurance (Medicare for me, allows) but it's also based on what you/ or your doctor claims you use/ or need. I overestimate what I need, because I don't want to be caught short..... Best of luck. Marsha

jvanet19

I love ConvaTech. I use 180 Medical and they work well with the company.

oldstone
Reply to Audrey Warren

I have a urostomy and I use Mercy Surgical, and I get my supplies within a week. I have never had a problem with them. I am also on Medicare.

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