Grandfathering

Sample Letter to Beneficiary from Supplier that Chooses to Grandfather
Our records show our company, [insert supplier name], is currently furnishing you with rented
[insert name of equipment].
Since January 1, 2011, Medicare has implemented a competitive bidding program for certain
durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS). On January 1, 2021,
Medicare will start new competitive bidding contracts with DMEPOS suppliers in your area. Under
this program, people with Original Medicare in your area will almost always need to buy or rent
certain medical equipment and supplies from suppliers that contract directly with Medicare to
furnish these items. Although we won’t be a Medicare contract supplier for your equipment starting
January 1, 2021, we qualify as a grandfathered supplier so you may continue to rent your equipment
from us. This also includes getting related accessories and supplies needed to operate the equipment
for the remaining rental months.
It is important for you to know you may change suppliers at any time. However, if you change
suppliers, you must get your [insert name of equipment] from a new Medicare contract supplier for
your area. To find a Medicare contract supplier for [insert name of equipment], visit
www.medicare.gov/supplier or call 1-800-MEDICARE (1-800-633-4227) and have your ZIP code
ready. TTY users should call 1-877-486-2048.
If you choose to use a new Medicare contract supplier instead of continuing to rent with us, the contract
supplier is required to provide you with the items included in its contract. [USE FOLLOWING
SENTENCE FOR RENTED DURABLE MEDICAL EQUIPMENT EXCEPT OXYGEN AND OXYGEN
EQUIPMENT:] The Medicare contract supplier will receive 13 additional months of rental payment for
medical equipment. [USE FOLLOWING SENTENCE FOR OXYGEN AND OXYGEN EQUIPMENT:] The
Medicare contract supplier will receive at least 10 months of rental payment for oxygen equipment. You
or your secondary insurer will be responsible for the 20 percent copayment for the monthly rental and any
unmet Part B annual deductible. If you continue to rent with us, you will be responsible for [insert # of
months] of monthly rental copayments and any unmet Part B annual deductible.
Please respond by checking the appropriate box below and mailing it to [insert supplier address] or
you may call us at [insert supplier phone number] to let us know if you would like to continue to
rent from us or switch to a contract supplier. Please respond by [insert date]. If you choose to switch
to a contract supplier, we will contact you to arrange a convenient time to pick up your equipment.
If you have any questions, please call us at [insert supplier phone number] or call 1-800MEDICARE (1-800-633-4227).

Customer Name (please print)

has decided to:

□ continue renting [insert name of equipment] from [insert supplier name]
□ NOT to continue renting [insert name of equipment] from [insert supplier name]
Signature

Date