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Will Medicare cover my durable medical equipment?

I have been having difficulty moving around my home, and my doctor wants to order some kind of durable medical equipment (DME) for me. Does Medicare cover DME?

 

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Posted December 6, 2021 by at United States in Medicare
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Durable medical equipment (DME) is equipment that helps you complete your daily activities. It includes a variety of items, such as walkers, wheelchairs, and oxygen tanks. Medicare usually covers DME if the equipment:

  • Is durable, meaning it is able to withstand repeated use
  • Serves a medical purpose
  • Is appropriate for use in the home, although you can also use it outside the home
  • And, is likely to last for three years or more

 
To be covered by Part B, DME must be prescribed by your primary care provider (PCP). If you are a skilled nursing facility (SNF) or hospital inpatient, DME is covered by Part A.
 
Whether you have Original Medicare or a Medicare Advantage Plan, the types of Medicare-covered equipment are the same. Examples of DME include:

  • Wheelchairs
  • Walkers
  • Hospital beds
  • Power scooters
  • Portable oxygen equipment


Under the durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) category, Medicare Part B also covers:

  • Prosthetic devices that replace all or part of an internal bodily organ
  • Prosthetics, like artificial legs, arms, and eyes
  • Orthotics, like rigid or semi-rigid leg, arm, back, and neck braces
  • Certain medical supplies 

Medicare Part B also covers certain prescription medications and supplies that you use with your DME, even if they are disposable or can only be used once. For example, Medicare Part B covers medications used with nebulizers. Medicare also covers lancets and test strips used with diabetes self-testing equipment.
Note that there are also certain kinds of equipment and supplies that Medicare does not cover, such as equipment for use mainly outside the home, and most equipment that is thrown out after one use or not used with the equipment.
 
To find out if Medicare covers the equipment or supplies you need, or to find a DME supplier in your area, call 1-800-MEDICARE or visit www.medicare.gov. You can also learn about Medicare coverage of DME by contacting your State Health Insurance Assistance Program (SHIP).

-Marci

Dear Marci is a free e-newsletter from the Medicare Rights Center (www.medicarerights.org), the nation’s largest independent source of information and assistance for people with Medicare. For more free answers to your Medicare questions, visit Medicare Interactive (MI) at www.medicareinteractive.org. Subscribe to Dear Marci by registering for your free account on Medicare Interactive. 


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Added: December 6, 2021