Durable Medical Equipment
Durable medical equipment is any medical equipment used in the home to aid in a better quality of living. It is a benefit included in most insurances.
Medicare Part B (Medical Insurance) covers medically necessary durable medical equipment (DME) that your doctor prescribes
for use in your home. Only your doctor can prescribe medical equipment for you.
DME meets these criteria:
- Durable (long-lasting)
- Used for a medical reason
- Not usually useful to someone who isn’t sick or injured
- Used in your home
DME that Medicare covers includes, but isn’t limited to:
- Air-fluidized beds and other support surfaces
- Blood sugar monitors
- Blood sugar (glucose) test strips
- Canes (however, white canes for the blind aren’t
- Commode chairs
- Continuous passive motion (CPM) machine
- Hospital beds
- Infusion pumps and supplies (when necessary to administer certain drugs)
- Manual wheelchairs and power mobility devices
- Nebulizers and nebulizer medications
- Oxygen equipment and accessories
- Patient lifts
- Sleep apnea and Continuous Positive Airway Pressure (CPAP) devices and accessories
- Suction pumps
- Traction equipment
All people with Part B are covered.
Your costs in Original Medicare
If your supplier accepts assignment, you pay 20% of the Medicare-approved amount, and the Part B deductible applies. Medicare pays for different kinds of DME in different ways. Depending on the type of equipment, you may need to rent the equipment, you may need to buy the equipment, or you may be able to choose whether to rent or buy the equipment.
Medicare will only cover your DME if your doctors and DME suppliers are enrolled in Medicare. Doctors and suppliers have to meet strict standards to enroll and stay enrolled in Medicare. If your doctors or suppliers aren’t enrolled, Medicare won’t pay the claims submitted by them. It’s also important to ask your suppliers if they participate in Medicare before you get DME. If suppliers are participating suppliers, they must accept assignment. If suppliers are enrolled in Medicare but aren’t “participating,” they may choose not to accept assignment. If suppliers don’t accept assignment, there’s no limit on the amount they can charge you.