Medicare Coverage of Durable Medical Equipment (DME)

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.

Woman outside using a walker

What are some examples of durable medical equipment?

The list of durable medical equipment that may be covered by Medicare includes (but isn’t limited to):

  • Air-fluidized beds
  • Blood sugar monitors and blood sugar test strips
  • Canes and crutches
  • Commode chairs
  • Continuous passive motion machines
  • Continuous Positive Airway Pressure (CPAP) machines and accessories
  • Enteral nutrition supplies and equipment
  • Glucose control solutions
  • Hospital beds
  • Hyperbaric oxygen therapy
  • Infusion pumps and supplies
  • Lancets and lancet devices
  • Nebulizers and nebulizer medications
  • Oxygen equipment and accessories
  • Suction pumps
  • Traction equipment

Walkers, wheelchairs, scooters and lift chairs are also common items that can fall under the classification of DME covered by Medicare.

What qualifies something to fall under covered durable medical equipment?

In order for an item to qualify as durable medical equipment and be covered by Medicare, it must meet each of the following criteria:

  • It is durable and can withstand repeated use.
  • It is used and will be used for a medical reason.
  • It is not typically useful to someone who does not have a medical issue.
  • It will be used in the home.
  • It has an expected lifetime of at least three years.

An item of durable medical equipment must be prescribed to you by a doctor in order to qualify for coverage by Medicare.

How much do DME items cost?

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.

Medicare Advantage plans can also cover 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 speaking with a licensed insurance agent at TTY Users: 711 24 hours a day, 7 days a week.

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