Monthly Tracheostomy Supply Replacements: How Much Insurance Covers

Key Takeaways:

The table below outlines the replacement frequency for most tracheostomy supplies. Tracheostomy tube replacements are provided once every three months rather than monthly.

Supply Type	Monthly Replacement Frequency
Saline Bullets	100 Bullets
Sterile Water	4 Bottles
Disposable Inner Cannulas	62 Cannulas
Trach-Suction Catheters	90 Catheters
Suction Yankauers	12 Yankauers
Trach Cleaning Kits	31 Kits
Suction Canisters	4 Canisters
Suction Tubing	8 Tubes
Heat & Moist Exchangers	62 HMEs
Trach Collars	31 Collars
Suction Filter	1 Filter Kit
Speaking Valve	1 Valve
Trach Tube	1 Every 3 Months

You can also check out this blog to learn more about what role each supply plays during at-home tracheostomy care: A Guide to Tracheostomy Supplies Covered By Insurance and Their Role in At-Home Care

Qualifying for Tracheostomy Supply Replacements Through Health Insurance:

The journey to ensuring proper tracheostomy care begins with recognizing that tracheostomy supplies, much like other medical devices and supplies, have a limited period of effective use. To qualify for replacements through insurance, certain criteria must be met. These often include recent medical necessity documentation, a current prescription from your doctor, and evidence supporting the need for replacement. Documentation requirements can vary based on your insurance plan and your previous supply orders.

Don’t worry—our product specialists are here to support you every step of the way. We’ll collaborate with your doctor’s office to gather the necessary documentation and secure your insurance coverage. Furthermore, we’ll proactively assist you each month to ensure timely refills, so you always have the supplies you need for effective and hygienic tracheostomy management.

Why It's Important to Change Your Tracheostomy Supplies:

Changing your tracheostomy supplies regularly is essential for ensuring both your health and the effectiveness of your supplies. Here are four key reasons why it’s important:

Helps Maintain Hygiene and Cleanliness
Regularly changing your tracheostomy supplies keeps the area around your tracheostomy site clean, reducing the buildup of dirt, bacteria, and harmful substances that can affect your health.
Reduces the Risk of Infections
When supplies are not changed frequently, bacteria and contaminants can accumulate, increasing the risk of infections like pneumonia or skin infections around the tracheostomy site. Keeping your supplies fresh lowers these risks.
Decreases Pooling of Secretions in the Trach Area
As secretions accumulate in and around the tracheostomy tube, they can cause blockages or discomfort. Changing your supplies regularly ensures that secretions are managed properly and that your airways remain clear.
Maintains the Efficiency of Your Equipment
Over time, tracheostomy equipment such as tubes and filters can wear out, reducing their effectiveness. By changing supplies as recommended, you ensure that your equipment continues to work efficiently, supporting optimal breathing and airflow.

Now that you know why regular replacement is essential, it’s equally important to track when your supplies need to be replaced. Below is a breakdown of the monthly replacement frequency for most tracheostomy supplies.

Tracheostomy Supplies Medicare Replacement Frequency:

This table below shows how much of each tracheostomy supply Medicare covers monthly. Note that trach tubes are the only items on this list that are not eligible for monthly replacement but are instead replaced every three months.

Supply Type	Monthly Replacement Frequency
Saline Bullets	100 Bullets
Sterile Water	4 Bottles
Disposable Inner Cannulas	62 Cannulas
Trach-Suction Catheters	90 Catheters
Suction Yankauers	12 Yankauers
Trach Care Kits	31 Kits
Suction Canisters	4 Canisters
Suction Tubing	8 Tubes
Heat & Moist Exchangers	62 HMEs
Trach Collars	31 Collars
Suction Filter	1 Filter Kit
Speaking Valve	1 Valve
Trach Tube	1 Every 3 Months

For a more technical breakdown of Medicare’s guidance around the Unusual Maximum Quantity of Supplies you can visit CMS.gov and view the Local Coverage Determination (LCD)

These recommendations are designed to help you stay ahead of wear and tear, ensuring your supplies remain effective and safe to use. For example, disposable inner cannulas and heat and moisture exchangers (HMEs) need frequent replacement to maintain optimal hygiene and functionality.

Medicare Advantage and Medicaid Plans

The following table represents Medicare’s replacement guidelines. When it comes to Medicaid or Medicare Advantage plans through companies like Aetna, Humana, UHC, BCBS, or more, these guidelines could vary. Our product experts have extensive knowledge of these guidelines and are here to help. They can assist you in understanding the allowable quantities of supplies and the specific requirements your insurance plan may have. By staying informed and working with our team, you can ensure you’re meeting your plan’s criteria while maintaining access to the supplies you need for effective tracheostomy management.

Conclusion

Regular replacement of tracheostomy supplies is essential for maintaining airway health and preventing complications. By understanding the lifespan of each supply, tracking when replacements are due, and being aware of Medicare and insurance guidelines, you can ensure the continuity of your care.

If you have any questions or need assistance navigating the replacement process, our tracheostomy supply specialists are here to help. Give us a call at 866.864.6332, and we’ll guide you through the process with clarity and care