Durable medical equipment (DME) coverage
Medicare Part B (Medical Insurance) covers medically necessary DME if you're eligible
Description
DME is defined as equipment that is:
- Durable (can withstand repeated use)
- Used for a medical reason
- Typically only useful to someone who is sick or injured
- Used in your home
- Expected to last at least 3 years
Coverage details
Medicare-covered DME includes, but isn't limited to:
- Canes
- Commode chairs
- Continuous Positive Airway Pressure (CPAP) therapy
- Crutches
- Glucose monitors and related supplies
- High frequency chest oscillation devices
- Hospital beds
- Infusion pumps and supplies
- Lymphedema powered devices
- Oxygen equipment and accessories (including oxygen humidifiers)
- Respiratory assist devices
- Walkers
- Wheelchairs and scooters
Medicare covers 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.
- You may be able to choose whether to rent or buy the equipment.
- Some items become your property after you’ve made a certain number of rental payments.
Where can I get covered DME items?
Who's eligible
Part B covers medically necessary DME if your doctor or other health care provider orders it for use in your home.
Provider requirements
Make sure your doctors and DME suppliers are enrolled in Medicare. It’s also important to ask your suppliers if they participate in Medicare or will accept assignment of your claims before you get DME.
Costs
After you meet the Part B deductible , you pay 20% of the Medicare-approved amount (if your supplier accepts assignment ).
It’s important to ask a supplier if they participate in Medicare or will accept assignment of your claims before you get DME. If a supplier participates in Medicare, they must accept assignment (which means, they can charge you only the coinsurance and Part B deductible for the Medicare-approved amount).
A non-participating provider doesn't have to accept assignment, but may choose to do so in your case. If a DME supplier doesn't participate in Medicare or won't accept assignment, you may be charged more. For rented DME, make sure the supplier is willing to accept assignment for all rental months, otherwise you’ll have to pay the full cost of your DME upfront. If this happens, Medicare will pay you later for the amount it covers after your claims have been submitted and processed by Medicare.