Are you aware that your durable medical equipment (DME) may be covered under Medicare? Medicare Part B (Medical Insurance) covers medically necessary durable medical equipment that your doctor prescribes for use in your home. Therefore, Medicare covers items like oxygen equipment and supplies, wheelchairs, walkers, and hospital beds ordered by a doctor or other health care provider enrolled in Medicare for use in the home. Some items must be rented. You pay 20% of the Medicare-approved amount, and the Part B deductible applies. Learn more about Medicare coverage of durable medical equipment and other devices.
Talk to your doctor and DME supplier.
Make sure 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 they submit.
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 (that is, they’re limited to charging you only coinsurance and the Part B deductible on the Medicare-approved amount). If suppliers are enrolled in Medicare but aren’t “contract suppliers,” they may choose not to accept assignment. If suppliers don’t accept assignment, there’s no limit on the amount they can charge you.
To find suppliers who accept assignment, visit Medicare.gov/supplierdirectory or call 1-800-MEDICARE (1- 800-633-4227). TTY users should call 1-877-486-2048. You can also call 1-800-MEDICARE if you’re having problems with your DME supplier, or you need to file a complaint. For more information, visit Medicare.gov/publications to view the booklet “Medicare Coverage of Durable Medical Equipment and Other Devices.””
Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program: If you have Original Medicare and live in a Competitive Bidding Area (CBA) and use equipment or supplies included under the program (or get the items while visiting a CBA), you generally must use Medicare contract suppliers if you want Medicare to help pay for the item.
Medicare Coverage of Durable Medical Equipment (DME) and Other Devices
Only your doctor can prescribe durable medical equipment for you that 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
- Durable medicare equipment 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 covered)
- Commode chairs
- Continuous passive motion (CPM) machine
- Crutches
- 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
- Walkers
Looking for Medicare coverage? We offer free comparisons for Medicare Advantage Plans (Part C), Medicare Supplement (Medigap), and Medicare Prescription Drug (Part D) Plans. Get a quote from Medicare.org, or contact a licensed sales agent at (888) 815-3313 – TTY 711 to help you find the right Medicare coverage for your needs.
Related Articles: