FAQs - Billing and Payment

  • *If there have been any changes to your insurance, this may delay your order.* Please update your health insurance by logging in to your account and providing the new information before the start of the new year.

  • Your cost will depend on your health insurance plan.

    If you have Medicare:

    Your out-of-pocket expense is 20% of the Medicare allowable. Medicare covers the other 80% for you. If you have a supplemental policy, you may not have any out-of-pocket expenses. Please note: Edgepark does not accept Medicare assignment for some items.

    If you have private health insurance:

    Your out-of-pocket costs will vary based on your coverage. If you have secondary insurance, or your primary insurance covers 100% of your costs, you may not have any out-of-pocket expenses.
     
    If you do not have Medicare or another insurance plan, or the items you need are not covered by your health insurance company:

    You can still purchase your medical supplies from Edgepark by paying out of pocket. We often offer a discount on these items.

  • If you have a balance due to Edgepark, you may pay by:

    • MasterCard, Visa, Discover, American Express, or debit cards – you can use any of these to make a payment online.
       
    • Electronic check, through our website.
       
    • C.O.D. (Please note: There will be a charge of $12.50 for using the C.O.D. option. A check or money order is required upon delivery. Cash will not be accepted.)
       
    • Personal check or money order (for phone orders only – orders will be shipped once your check or money order is received). Please send these to the following address:
      Edgepark Medical Supplies, P.O. Box 1210, Twinsburg, OH 44087
       

     

  • Yes. If you do not have health insurance, or the items you need are not covered by your health insurance policy, Edgepark extends a discount on most items.

  • Your copay depends on your health insurance coverage. The following are examples of how a copay is calculated. Keep in mind that deductibles may also apply.

    If you have Medicare, Edgepark accepts Medicare “assignment” on most items: This means that Edgepark accepts Medicare’s allowed reimbursement price for your supplies, instead of our regular, list price. Medicare covers 80% of the allowed price, meaning you must pay the other 20%, which is your copay.

    Example:

     

    • An item has a retail price of $151.32, but the Medicare allowable price is $100.00 (allowable prices vary by state).
       
    • Medicare will pay 80% of the $100.00 allowable price, which is $80.00.
       
    • That means that your copay will be 20% of $100.00, or $20.00.
       
    • If you have a supplemental policy, you may have no out-of-pocket costs.


    If you are insured through a private health insurance plan: Health insurance companies offer different coverage. In some cases, your health insurance plan might cover the entire cost of your medical supply order, and you will not have a copay. Because Edgepark is an in-network provider for most health insurance plans nationally, you have low out-of-pocket expenses for most supplies.

    Here is an example of a copay, for a health insurance plan paying at 90%:

    • The retail price is $58.95, but your health insurance plan has a contracted price for that item of $38.
       
    • The plan will cover 90% of $38, or $34.20.
       
    • Your copay will be the other 10%, or $3.80.
       
    • If you have a secondary health insurance plan, you may have no out-of-pocket costs.
       
    • Your out-of-pocket costs may differ if you have a deductible that has not been met for the current plan year, or items are not covered, or are excluded.
  • Edgepark’s policy is to collect any monies owed prior to shipping. We will bill you if it is determined that any items are not covered.

  • The pricing you see on the product detail page will depend on whether you’re logged in to your account online and if your health insurance information has been verified.

    If you are logged in to your account online and your health insurance information is already verified, then you will be able to see pricing on the product detail page.

    For customers who are logged into their account online, but do not have health insurance, they will see retail pricing on the product detail page.

    If, however, customers do have health insurance, but that information has not yet been verified, they will see estimated pricing on the product detail page, based on available information.

  • Yes, you can still order supplies. You'll need to update your health insurance information at the time you are placing or confirming your next order, either by logging in to your account  or by calling 1-888-394-5375. Please have your new health insurance card available. Keep in mind that Edgepark will need to contact your new health insurance provider to verify that the information is correct, and that we are an in-network provider. *This may delay your order; to prevent this, please contact us prior to 2016.

    We will contact you via e-mail or by phone if there are any questions regarding this change. Once your health insurance is verified, you will receive your supplies in 1-3 business days, unless prior authorization or prescription confirmation are required.

  • Payment plans on current orders are not available through Edgepark, but you can make a partial payment on past due balances. With a partial payment plan, you’ll need to have at least 30% of your balance paid to complete a new order.

    You can set up a payment plan for a balance on your account through our website.

    Please call us at 1-800-307-5930 with additional questions on partial payments.

  • Sometimes, your health insurance provider will cover an item, but they may require us to obtain authorization from them first, before we ship the item to you and submit a claim on your behalf. Once we get the prior authorization from your health insurance provider, we will ship you the item.

  • There are several ways you can determine your supply limits. You can:

     

    • Log in to your account and this information will be available during the order process.
       
    • Existing customers can call an Edgepark Customer Care Specialist to review the information that has been provided by your health insurance or doctor.
       
    • Contact your health insurance provider directly.
  • When you are logged in to your account, and your health insurance information has already been verified, you will see supply limits information during the checkout process.

    Onscreen prompts will be able to explain:

    • What your supply limits are based on your health insurance provider.
       
    • Options on placing your order: For example, you can change the number of supplies, split your order, delay the delivery date until your whole order can be sent, or pay out of pocket for any supplies that are over your limits.


    Please note:
    If you want to order extra supplies, but want your health insurance company to pay for them, we will only ship you the supplies that are within your limits. We will hold the extra supplies until we are able to obtain a Physician’s Written Order, or PWO, from your doctor. Once we have the PWO, we will submit it to your health insurance provider to see if they will cover the supplies. After your health insurance provider has approved the additional supplies, we will ship the rest of your order.

  • No, you do not need both. Edgepark asks for this health insurance information to ensure that you receive the maximum supply coverage by your plan(s).