Durable Medical Equipment, or DME, is devices and supplies that you need to receive care in your home. It is covered if your doctor prescribes, and Medicare has made a coverage determination that it is a device that is actually needed to treat an illness. In addition, it must be durable, intended to treat an illness, not useful for someone who isn’t sick or injured, intended for use in your home, and likely to last at least three years. Some items that do not meet all of these criteria are included, for example, blood sugar test strips.
What, Exactly, Is Covered?
The list includes, but is not limited to:
- Artificial arms, legs, and eyes
- Blood sugar meters
- Blood sugar test strips
- Commode chairs
- Continuous passive motion devices
- Continuous Positive Airway Pressure (CPAP) devices
- Hospital beds
- Home infusion services
- Infusion pumps & supplies
- Lancet devices & lancets
- Nebulizers & nebulizer medications
- Ostomy supplies
- Oxygen equipment & accessories
- Patient lifts
- Pressure-reducing support surfaces
- Prosthetic devices
- Suction pumps
- Traction equipment
- Wheelchairs & scooters
If you want information on another type of device or to find out if a particular item is covered, you can use Medicare’s “What’s Covered” mobile app, which is available for iPhone and Android.
How Much Will I Have to Pay?
In Original Medicare, you may have to rent the equipment, buy the equipment, or you may have a choice. In a Medicare Advantage Plan, the plan determines whether it will be a purchase or rental and what you will pay. In Original Medicare, DME is covered under Part B and your cost is 20%.
What If the Plan Won’t Provide DME I Think I Need?
Denial of service can be appealed in both Original Medicare and Medicare Advantage Plans.
What About Long-Term Rentals?
If Medicare originally required you to rent them items and you have continuously used it for 12 months, ownership transfers to you at the start of the 14th month.
Will Medicare Pay for a Portable Oxygen Concentrator for Air Travel?
No, because this is not a use associated with your home. You will have to make alternative arrangements.
For more information on the durable medical equipment that is covered by Medicare, please give us a call today. If you are shopping for rates in your area, you can request a no-obligation quote so you can compare the rates side by side with the top carriers.