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Medicare Coverage for Durable Medical Equipment

http://www.medicare.gov

What is durable medical equipment (DME)?

Medical equipment and supplies used in the home are called durable medical equipment (DME). Medicare specifies what equipment is covered and what is not. Examples of covered items are:

  • crutches and walkers
  • hospital beds
  • oxygen tanks and nebulizers
  • raised toilet seats
  • wheelchairs.

Personal items, such as hearing aids and dentures, are examples of items that are not covered.

What is Medicare?

Medicare is a federal government program. It provides healthcare coverage for people age 65 or older. It also provides coverage for people of any age who have certain disabilities.

Medicare is divided into 2 parts: Part A and Part B. Each part covers different services. Both parts pay toward costs for services that are medically necessary.

When does Medicare cover DME?

Generally, Medicare Part B helps pay for medical equipment that meets the following requirements:

  • It is prescribed by a doctor.
  • It is medically necessary.
  • It will be used in the home.
  • It fills a medical need for you. It’s not just a convenience.
  • It can be used over and over again.

Medicare pays for different kinds of medical equipment in different ways. Some equipment must be rented. Other equipment must be purchased. Some equipment may be rented or purchased. Medicare pays for rentals lasting no longer than 15 months.

Medicare pays 80% of the approved amount. You pay the other 20% plus your deductible. If the supplier has not agreed to accept the amount Medicare offers to pay as payment in full, you may be billed additional fees.

For more information, call Medicare at 1-800 MEDICARE (1-800-633-4227). Or visit the Web site at http://www.medicare.gov.


Written by Carolyn Norrgard, RNC, BA, MEd; Carol Matheis-Kraft, PhD, RNC; and Mercedes Bern-Klug, MSW, MA, for RelayHealth.
Adult Advisor 2012.1 published by RelayHealth.
Last modified: 2011-07-07
Last reviewed: 2011-07-05
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
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