Does Medicare cover any costs for G-tube feeding needs for adults?

whos_your_dolly
  • By whos_your_dolly · March 11, 2009 at 10:04 pm · 8 replies
  • In Home tube feeding (HEN, enteral nutrition)
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am wondering does Medicare cover the cost of supplies needed for tube feeding through a g-tube? My son is 18 and so far Medicaid has covered all of his needs. They will discontinue covering the cost of his liquid supplement when he is 21 though. Does Medicare cover anything at all? Im beginning to have my doubts
Thanks

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8 replies   

whos_your_dolly

am wondering does Medicare cover the cost of supplies needed for tube feeding through a g-tube? My son is 18 and so far Medicaid has covered all of his needs. They will discontinue covering the cost of his liquid supplement when he is 21 though. Does Medicare cover anything at all? Im beginning to have my doubts
Thanks

MarieTwinTubes

Hi. If a home health agency delivers your formula and supplies, they shuold be able to check that out for you. And you could call the medicare number. I am assuming your son already gets medicare?

I am 67 and medicare pays on my formula and suppies.

Best of everything in getting your son's needs taken care of.

Also, check out the equipment exchange at www.oley.org for a list of free formula and supplies available.

Cheers for life and breath!
Marie

ShariEC

As a rule Medicare cover tube feeding formula and supplies if the it is 1)going through a feeding tube 2)expected to be needed for longer than 3 months 3)there is a "permanent" non-function of the intestines or the organs required to get the food to the intestines (ie dysphagia, esophageal fistula, head and neck cancer). Medicare covers at 80% of allowable charges. Since your son has Medicaid now I would assume he can continue with medicaid as a secondary insurance to pay for the 20% that medicare does not cover. Every state is different and I would suggest you talk to a Medicaid case worker and find out the rules for your state about how and when a trasition to Medicare will happen.

Take care!
Shari

whos_your_dolly

Thank you for the information! I have two reasons for asking.
My son who is 18
He was a preemie with many complications and has been on a feeding tube all his life [most recently a Mic-key] So far Medicaid has paid for all his feeding needs including the bags, tubes, etc.
I'm told once he turns 21 Medicaid will no longer pay for his liquid food, but I don't know about his tube replacements, feeding bags, catheter extentions, etc.

My dad who is 93
He had a Mic-Key feeding tube put in a couple of days ago because they believe he is aspirating food and liquids into his lungs causing recurring bouts of pneumonia. I'm wondering if Medicare will cover the costs of his food, bags, pump, tube replacements and all once he comes home from the hospital [God willing] He also has supplementary Blue Cross I think.

So I am wondering about both cases.
Thanks.

prettykitty

I am on Medicare and Medicaid together, and they are covering ALL of my supplies I need for my feeding tube. Whatever Medicare doesn't cover, Medicaid pays the difference.
I'd talk to your son's case worker about getting on both of these together to pay for all the feeding supplies.

whos_your_dolly

Are you over 21 Kitty? Thats when medicaid will stop paying for my son's stuff. My dad unfortunately passed away so now I don't need to find any more out about paying for his needs. Wish I did.
God bless
Marilyn

whos_your_dolly

Here is a site that shows people changing mic-key tubes at home.

http://www.youtube.com/watch?v=Mn4ePSBiCTk

prettykitty

I'm 27 years old and was on just Medicaid since 2000 after I graduated high school. Last year, they put me on both Medicare and Medicaid.
I noticed on the slips of paper I get every month through Medicare that they cover a small portion of my feeding supplies, and Medicaid coveres the rest of the balance. Even when I was 21 and was only on Medicaid, they covered all my other medical supplies without any trouble (intermittent catheters, diapers, gloves, ostomy appliances, ect.).
Hope this helps!
Jessie

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