A Medicare capped item is a good that may be medically necessary that is not normally purchased or does not need an ongoing investment on the part of the patient. Hospital beds, infusion pumps, nebulizers, wheelchairs and CPAP devices are common examples of items that Medicare may cover as a capped item. A capped item means that there is a limit to what Medicare will pay for the listed item and a person may have to pay the remaining costs of the item himself. If an item is medically necessary, a patient may also have to obtain a certificate of Medical necessity from a doctor.
Medicare puts safeguards in place for consumers. The most common is spreading the co-insurance amount paid by the patient out over a long time. The spread out costs help protect a person who purchases the wrong item and makes larger purchases more affordable. A patient who purchases the wrong item and then returns it does not always need to make the extend coinsurance payments that he would have to make otherwise. If a person is not sure what counts as a caped good for Medicare, he should check with his local office or Medicare.gov.
Medigap policies may or may not cover capped items covered by Medicare. It depends on the plan the patient has. Not all of the supplemental plans will cover all the gaps that occur in the government-sponsored program. A person should check with his insurance company about what is covered if he is not sure. Although the plans are standardized, companies are free to offer coverage in addition to what the federal government tells them they must offer through any of the plans designated by the letter A-K.