Hieline does not accept insurance or Medicare. We are a retail store, and we sell directly to you, so the price you see is the price you pay. That still leaves you with options. Many private insurance plans that include durable medical equipment (DME) coverage will pay you back after you buy. Medicare works differently. Medicare does not reimburse you for equipment you buy from us, so if you want Medicare to pay, the process has to start with Medicare before you buy anything.
This guide walks through each path, so you can choose the right one before you spend money.
The short answer
- Private insurance with DME coverage. You can buy from us, pay at checkout, and file a claim with your insurer to be paid back.
- Medicare. Medicare will not pay you back for equipment you buy from us. Start with your doctor and a supplier that is enrolled in Medicare.
- Medicare Advantage. Call your plan before you buy. Each plan sets its own rules and its own network of suppliers.
- Medicaid. Hieline does not bill Medicaid. Contact your state Medicaid program or your caseworker first.
Private insurance: buy now, claim later
If your plan covers durable medical equipment, you can usually buy the equipment yourself and then ask your insurer to reimburse you. How much you get back, and whether you get anything back, is up to your plan. A few calls before you buy will tell you what to expect.
Step 1. Call your insurer before you buy
The number is on the back of your insurance card. Ask these questions and write down the answers.
- Does my plan cover durable medical equipment, and does it cover this kind of item?
- Will you reimburse a purchase from a store that is outside your network?
- Do you need to approve the purchase before I buy? This is often called prior authorization.
- What paperwork do you need with my claim?
- How much of the price will you pay back, and how much of my deductible is left?
Note the date of the call, the name of the person you spoke with, and any reference number they give you. If your claim is questioned later, that record helps.
Step 2. Get the paperwork from your doctor
Most insurers want a prescription or written order from your doctor. Some also ask for a letter of medical necessity, which explains why you need the equipment. Both come from your physician. Hieline does not write these letters and does not supply a template for one.
Step 3. Buy the equipment
Order online or visit our Plano showroom. If you want to spread out the cost while you wait for your claim, financing is available through CareCredit.
A prescription can also matter for sales tax. Some items that are taxable in Texas are tax-free with a prescription. Our Sales Tax page explains which items qualify and how to attach your prescription before you add the item to your cart.
Step 4. File your claim
Send your insurer its claim form, your receipt and your doctor's paperwork. Your order confirmation lists each item and its price. Your insurer may also ask for billing codes, and we can give you the billing codes for your purchase. Contact us with your order number and we will send them. Keep a copy of everything you send.
We cannot promise what your plan will pay
Every plan has its own rules. Some pay part of the price, some pay the full allowed amount, and some pay nothing for a store outside their network. Your insurer is the only one who can tell you, so ask before you buy.
Medicare: start with Medicare
Medicare Part B covers medically necessary durable medical equipment when your doctor orders it for use in your home. Medicare pays only for equipment that comes from a supplier enrolled in Medicare. Hieline does not accept Medicare, so Medicare will not pay you back for equipment you buy from us, even if you would have qualified.
That is why the order of steps matters. If you want Medicare to pay, do these things before you buy anything.
- See your doctor. Medicare needs an order from your doctor showing that the equipment is medically necessary for use in your home. For a power wheelchair or scooter, Medicare requires a face-to-face exam and a written prescription from your treating provider.
- Find a supplier enrolled in Medicare. Use Medicare's Find medical equipment and suppliers tool. Ask each supplier whether it accepts assignment, which limits what it can charge you.
- Let the supplier handle approval. Some power wheelchairs need prior authorization from Medicare. The supplier usually sends that request.
- Pay your share. After you meet your Part B deductible, you generally pay 20% of the Medicare-approved amount when the supplier accepts assignment.
Medicare covers some equipment in full, some only in part, and some not at all. Our guides explain how Medicare treats lift chairs, hospital beds, patient lifts, bathroom safety, walkers, rollators and canes and ramps.
If you have a Medicare Advantage plan
Medicare Advantage plans are run by private insurance companies approved by Medicare. Each plan sets its own rules and its own network of suppliers, so call your plan before you buy and ask how it covers the equipment you need.
When Medicare members buy from us anyway
Some Medicare members choose to pay out of pocket. Medicare may not cover the item they want, such as a bath seat, a ramp or the furniture part of a lift chair. Medicare may approve a different model than the one they prefer. Or they may not want to wait for an approval. In any of these cases you can buy from us like any other customer. Just know before you order that Medicare will not pay you back.
What Hieline can and cannot do
We can:
- Give you the billing codes for your purchase, for your insurance claim.
- Help you choose the right equipment before you buy. Talk to an expert on our team.
- Offer financing through CareCredit.
We cannot:
- Bill Medicare, Medicaid or any private insurance.
- Write a letter of medical necessity or supply a template for one. That comes from your physician.
- File a claim for you, or tell you what your plan will pay.
Common questions
Does Hieline accept insurance?
No. We sell directly and do not bill any insurance. If your private plan covers durable medical equipment, you can buy from us and file a claim with your insurer to be paid back.
Does Hieline accept Medicare?
No. Medicare pays only for equipment from suppliers enrolled in Medicare, so Medicare will not reimburse a purchase from Hieline. If you want Medicare to pay, start with your doctor and a Medicare-enrolled supplier.
Can I buy from Hieline and send my receipt to Medicare?
No. Medicare will not pay you back for equipment bought from us. Decide whether you want Medicare to pay before you order.
Will my private insurance pay me back?
It depends on your plan. Many plans with DME coverage reimburse members who buy their own equipment, and some do not pay for stores outside their network. Call your insurer before you buy.
Do I need a prescription to buy from Hieline?
You do not need a prescription to buy most equipment from us. Your insurer will likely want one for your claim, and a prescription can make some items tax-free in Texas.
Can you give me billing codes for my claim?
Yes. Contact us with your order number and we will send the billing codes for your purchase.
Can you write a letter of medical necessity?
No. A letter of medical necessity comes from your physician. We do not write one or supply a template.
How to decide
- If you want Medicare to pay, stop here and start with your doctor and a Medicare-enrolled supplier.
- If you have Medicare Advantage or Medicaid, call your plan or your caseworker before you buy.
- If you have private insurance with DME coverage, call your insurer and ask the questions above.
- Get your prescription and any letter your insurer needs from your doctor.
- Buy from us, then file your claim with your receipt and the billing codes we send you.
Questions about a specific product before you buy? Talk to an expert or call us at 1 (855) HIELINE.
