Education Center
A common cause of surprise denials — and how we prevent it.
Medicare generally won't pay for a new item if you already have one that serves the same purpose and it's still within its useful lifetime (often about 5 years). This is the “same or similar” rule.
If you — or a previous supplier — already billed Medicare for, say, a walker or a wheelchair, a second one may be denied even if your situation changed. It can also happen if you switched suppliers.
Before we deliver, we check your equipment history for same-or-similar conflicts. If there's a flag, we document the change in your condition, pursue an exception or upgrade where appropriate, or lay out a clear private-pay option — so you're never blindsided by a denial.
This page is general information, not medical advice. Talk to your healthcare provider about your specific situation. Medicare coverage depends on medical necessity and documentation and is not guaranteed.
