Medicare Part B (medical insurance) covers durable medical equipment (DME) if it is considered medically necessary.
A variety of items such as crutches and blood sugar monitors can fall into a coverage category of durable medical equipment that is covered by Medicare Part B.
Below is a look at how durable medical equipment is covered by Medicare and some of the common items that can often be covered as DME.
The list of durable medical equipment that may be covered by Medicare includes (but isn’t limited to):
In order for an item to qualify as durable medical equipment and be covered by Medicare, it must meet each of the following criteria:
An item of durable medical equipment must be prescribed to you by a doctor in order to qualify for coverage by Medicare.
If your DME supplier accepts Medicare assignment, you will typically pay 20 percent of the Medicare-approved amount for a DME item, after you meet your Part B deductible (which is $185 per year in 2019).
If your DME supplier does not accept Medicare assignment, you may be charged up to 15 percent more than the Medicare-approved amount. This extra cost is called an “excess charge.”
Depending on the type of DME you need, you may be required to buy it or rent it. You may also be given the option to either purchase or rent your DME.
Part B isn’t the only type of Medicare coverage that can help beneficiaries save money on durable medical equipment.
Medicare Advantage, or Medicare Part C, provides all the same benefits as Medicare Part A and Part B. This means that a Medicare Advantage plan will cover DME the same way Medicare Part B does.
Many Medicare Advantage plans also offer benefits not covered by Original Medicare. Some of these additional benefits can potentially include coverage for in the future:
If you’d like to learn more about Medicare Advantage plans and how they may offer coverage for the durable medical equipment you need, you can compare plans available in your area by calling to speak with a licensed insurance agent.
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