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Durable Medical Equipment

Durable Medical Equipment (DME) and supplies usually fall under Part B of Medicare. These consist of medical equipment and supplies needed at home and approved as such by a doctor. This article provides an overview of what is covered and associated costs.

Durable Medical Equipment

Durable Medical Equipment (DME)

Medicare coverage includes durable medical equipment (DME) and medical supplies. DME is designed for long-term use (expected lifetime of at least three years) and includes equipment such as personal mobile carriers, hospital beds, personal care aids, prostheses (artificial limbs), orthotics (therapeutic footwear), oxygen concentrators and other items.

If equipment has to be rented, check with Medicare as it will determine the quantum of rental payment. Medicare prefers more expensive equipment to be rented rather than purchased outright. Medicare makes the decision whether to buy or rent, not you, based on cost and other factors.

Enrollment

If you have Medicare Part B you are covered for DME and supplies. There is no separate enrollment for DME. Your doctor has to prescribe the necessary DME for use in your home.

Your doctor and DME suppliers should be recognized and authorized by Medicare. If they are not, Medicare may not pay the claims submitted by doctors or for the DME equipment rented or purchased from an unauthorized supplier. All suppliers must comply with the Medicare program’s supplier standards and quality standards to get accredited by Medicare.

Coverage examples (not an exhaustive list)

Below are typical examples of durable medical equipment and supplies covered by Medicare. Note that this is not an exhaustive list.

  • Air-fluidized beds; hospital beds
  • Blood sugar monitors and test strips
  • Canes (excluding cane for the blind) and crutches
  • Specialized Commode chairs
  • Continuous passive motion (CPM) machine
  • Infusion pumps and supplies; suction pumps
  • Wheelchairs (both manual and electric), walkers
  • Nebulizers, oxygen equipment, and accessories
  • Sleep apnea, and
  • Traction equipment.

Out-of-pocket Costs

You will generally have to pay 20 percent of the Medicare-approved amount for the equipment or supplies as coinsurance after your Part B deductible has been met. Any other costs beyond the Medicare-approved amount will also have to be borne by you.

Remember, Medicare will pay only if your doctor and DME supplier are recognized and authorized by Medicare. Make sure this is the case otherwise you may end up paying all of the cost.

                                                                                                                                                  

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Last Updated: 11-17-2019