Will Medicare Pay for My Durable Medical Equipment?
Durable medical equipment (DME) is reusable medical equipment, such as walkers, wheelchairs, or crutches. If you have Medicare Part B, Medicare covers certain medically necessary durable medical equipment if your physician or treating practitioner prescribes it for you to use in your home.
To be covered, the prescribed medical equipment must be:
- Used for a medical purpose.
- Not typically useful if you aren’t sick or hurt.
- Used in your home.*
*If you are currently residing in a hospital or nursing home that is providing you with Medicare-covered care, these facilities don’t qualify as your “home.” However, a long-term care facility does qualify as your home. If you’re staying in a skilled nursing facility and the facility provides you with durable medical equipment, the nursing facility is responsible for the durable medical equipment.
Some examples of durable medical equipment that Medicare covers may include, but isn’t limited to: Hospital beds, infusion supplies, oxygen equipment, patient lifts, and blood sugar monitors. If you have questions about whether a particular item or supply is covered, call 1-800-MEDICARE (1-800-633-4227). TTY users call 1-877-486-2048. Medicare customer service representatives are available 24 hours a day, seven days a week.
For more information, see this article on Medicare coverage of durable medical equipment.
Where can I get durable medical equipment?
If you’re enrolled in Original Medicare, you need to get your durable medical equipment from a supplier that is enrolled in the Medicare program, or Medicare won’t pay for the equipment. For the lowest costs, find suppliers that are “participating,” meaning they accept the Medicare-approved cost for the equipment and will not charge you above that amount. To find Medicare-participating suppliers, visit the Medicare.gov Supplier Directory. If you live in an area that is part of Medicare’s Competitive Bidding Program, you’ll need to get equipment from suppliers that are contracted by Medicare. For more information on the Competitive Bidding Program and to find out if you live in a region that is affected, visit Medicare.gov.
Medicare Advantage plans (like HMOs or PPOs) must cover at least the same level of coverage as Original Medicare. However, costs may vary, depending on your Medicare Advantage plan. If you are in a Medicare Advantage plan and you need durable medical equipment, call your plan directly to find out if the equipment is covered and to see how much you will have to pay.
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