Durable Medical Equipment and Medicare

Medicare Part B covers the Durable Medical Equipment (DME). These are equipment that serves a medical purpose, able to withstand repeated use, and is appropriate for use in at home.

There are many important things to know about Medicare’s coverage for DME. Below are pieces of information that will help you know whether/how you are covered.

Eligible equipment

Medicare’s DME benefit does not cover all medical equipment. Medicare only covers DME if your provider says it is medically necessary for use in the home. You also must order your DME from suppliers who contract with Original Medicare or your Medicare Advantage Plan. However, Medicare Advantage Plans may have additional requirements you need to meet before your DME is covered.

DME coverage

Depending on what type of equipment you need, Medicare will require that you either rent or buy DME. There are also special rules when you need oxygen equipment. Medicare typically only pays for standard equipment that meets your health needs. If you want special features or upgrades, you may have to pay more.

Maintenance

The costs for maintenance and repair of your DME will depend on whether or not you rent or buy the equipment. Medicare may also cover the replacement of the equipment.

Note: If Medicare denies coverage for your DME, you have the right to appeal the decision.

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