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Medicare will cover many pieces of Durable Medical Equipment. Part B will include most medical equipment you may need. Coverage can include prescriptions that may accompany equipment, like medications with a nebulizer. Equipment is essential for so many because it can help with daily tasks. Let’s take a look at the Durable Medical Equipment Medicare will cover and discuss the guidelines for coverage. Then, we can answer some common questions on the topic.
Medicare Guidelines for Durable Medical Equipment
Part B will cover Durable Medical Equipment you’ll use at your home if your doctor decides you need it. Medicare won’t cover all devices, but it does include a good majority. You’ll be able to use the Durable Medical Equipment in your home or a long-term care facility. If you have to stay in a skilled nursing facility, the facility will provide you with your equipment. Part A covers skilled nursing facilities, so your devices will be covered, inpatient too.
Eligibility Criteria for Medicare to Cover Durable Medical Equipment
- Endure repeated use
- Serve a medical purpose
- Must be appropriate for home use
What Equipment Does Medicare Pay for?
- Glucose monitors and strips
- Hospital beds
- Lancet devices & lancets
- Wheelchairs & scooters
- Commode chairs
- Oxygen equipment & accessories
- Suction pumps
- Continuous Positive Airway Pressure (CPAP) devices
Durable Medical Equipment that Medicare Doesn’t Cover
While Medicare covers a wide range of medical equipment, it doesn’t cover everything.
Some supplies and equipment that aren’t covered can include:
- Equipment to help you outside your home
- Equipment intended only to make things convenient and comfortable—for example, stairway elevators, air conditioners, and toilet seats
- Disposable items. For example, Medicare won’t cover incontinence pads, catheters, facemasks, or compression stockings
- Changes to your home. Modifications may include ramps or broader doors for wheelchair access
- Equipment not suitable for use in your home
Purchasing vs. Renting Durable Medical Equipment Through Medicare
Durable Medical Equipment can end up being quite expensive. You may find equipment available for purchase or rental. In most cases, Medicare pays to rent medical equipment. But Medicare will buy some equipment that’s inexpensive like a walker or cane.
Medicare usually will help with any repairs or replacements you may need for your device. Sometimes you need the equipment longer than a few months. Medicare may buy equipment rather than renting for situations like these.
Criteria for Medicare to Cover a Replacement for Durable Medical Equipment
- There’s extensive damage.
- If it’s more than five years old
To ensure coverage, you’ll need to order from an equipment supplier who’s Medicare-approved.
Durable Medical Equipment Suppliers Approved by Medicare
Does Medicare Advantage Cover Durable Medical Equipment?
Medicare Advantage plans must offer the same level of coverage through Medicare. But, often, you’ll find many more perks with an Advantage plan such as extra coverage.Advantage plans come from private insurance companies. You’ll want to confirm with your plan to ensure your equipment has coverage.