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Durable Medical Equipment Covered by Medicare


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?

Medicare covers the following durable medical equipment.

What DME is Not Covered By Medicare?

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

  • Lost
  • Stolen
  • 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

To get coverage for equipment, you’ll need to get your supplies from a Medicare-approved supplier.  You can check Medicare’s website to be sure that you find a qualifying supplier.

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.

FAQs

Does Medicare cover walkers?
Part B benefits will cover walkers as long as your walker is medically necessary, and you have a prescription from the doctor.
Does Medicare cover Hoyer lift?
 Hoyer lifts are a brand of patient lifts for those with mobility difficulties. Part B will either rent or buy the equipment. Medicare will cover ten months of your rental if you end up renting a lift. After your rent for ten months, you’ll get the option to buy the lift. If you decide to buy your lift after ten months, Medicare will pay for three more payments before you own the lift. If you don’t want to buy the lift, Medicare will pay a total of 15 monthly payments. After 15 months, you’ll have to start paying the rental fee. Hoyer lifts cost an average of $1,000, so insurance is crucial to keeping costs down.
Does Medicare cover gloves?
Part B will cover rubber gloves as long as they’re for use with patients with ESRD. Medicare won’t include any disposable latex or nitrile gloves.
Is the UPWalker covered by Medicare?
Durable Medicare Equipment suppliers must accept Medicare and the UPWalker suppliers do NOT accept Medicare, so even with a prescription, Medicare won’t cover the UPWalker. Simply because the supplier won’t accept Medicare as payment.
Does Medicare cover walkers with seats?
Medicare will cover the cost of walkers intended for use inside the home. Part B covers a portion of the cost for these when they’re medically necessary.

How to Find Medicare Coverage for Durable Medicare Equipment

You may have questions or concerns about your Medicare coverage for Durable Medical Equipment. Medigap policies can help you with the costs of DME items you may need. Our agents can answer any coverage questions you may have. We can also look at different plans that may better suit your needs. Call us today for a quote. Our services are free to you! You can also compare rates online today.

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Lindsay Malzone

Lindsay Malzone is the Medicare expert for MedicareFAQ. She has been working in the Medicare industry since 2017. She is featured in many publications as well as writes regularly for other expert columns regarding Medicare. You can also find her over on our Medicare Channel on YouTube as well as contributing to our Medicare Community on Facebook.

20 thoughts on “Durable Medical Equipment Covered by Medicare

  1. Hello, is it possible for me get a DME prescription from my doctor via Telehealth and still be covered by Medicare Part B? Assuming my doctor deems it medically necessary, does Medicare allow 80% coverage even if I live in a big city and not a rural area? I read somewhere telehealth coverage has been expanded during Covid. Was there Telehealth coverage for Part B DME prior to Covid and will it go back to being that way?

    1. Hi Sam! Yes, you can do a telehealth appointment with your doctor and they can provide you with a prescription for DME that the supplier will accept. Telehealth appointments have always been treated the same as a face to face doctor’s appointments. I hope this helps!

      1. Hi Sam! You would need to do a telehealth appointment with your doctor who would then write you a prescription for the DME equipment and send that prescription over to the DME provider.

  2. Hi; I work in healthcare and I have a hard time finding dme suppliers / supplies for Medicare patients. How would a doctor submit an order for dme through CVS or Walgreens?

    1. Hi Gaby. Is CVS or Walgreens the actual provider of the equipment? I would recommend using the Medicare DME provider tool and ask the provider directly if they are partners with CVS or Walgreens.

  3. Hi, a good friend of mine has a rare muscular progressive disease. He has a prescription from his Dr. for a tube bench or transfer tub bench next to shower and hand rail for shower. I am wondering if Medicare will cover that? And how to find a Medicare approved DME provider. So far, I cannot find anything.

    1. Hi Lori! We have some information on bathroom safety devices, but normally Medicare does not cover those types of items even though they are medically necessary. However, Medicare is always updating these guidelines and could cover them under certain circumstances. I’ve also heard of some Medicare Advantage plans covering them. Your best option is to call an agent, they will have the resources to determine if it will be covered. Your friends doctor should also be able to tell them as well as provide information on a DME provider.

  4. hi my mother has medicare and medical and she is home having ihss and us kids take care of her around the clock she has a wound that has to fistula that one has opened up from the small bowel and is coming into the wound and everything she eats and drinks comes out these wounds. she has no stomach do to her stomach turning gangrene and killed it with some of her intestines. im trying to get wound bags and supplies but a lot of places say they don’t have wound bags that are 6in x 9 in to cover both sights I feel like we have been put out to fend for are selfs but are having a hard time.

  5. On 7-21-2020 CVS Pharmacy filled a DME prescription for me for test strips. They offer delivery of prescriptions but declined delivery of this prescription (#1792800). I offered to pay extra. The pharmacy tech and the pharmacist both stated Medicare would not allow the pharmacy to deliver my prescription. I am unable to determine if the pharmacy acted correctly and believe I have been wronged – either by CVS or Medicare. (DME prescriptions are Medicare Part B).

    1. I would think this is an error on the pharmacy’s part. I would recommend contacting the manufacturer that makes the test strips directly to see if they will deliver them. Or, you can contact Medicare directly to get this issue cleared up.

  6. Hello. Medicare paid for a rollator in September for my elderly mother. Since then she has fell twice and has limited mobility and uses a wheel chair at Rehab. Will Medicare allow a wheelchair since they just bought the walker?

    1. Hi Karen! It’s really a case by case scenario. However, I would think that as long as your doctor finds it medically necessary, Medicare should help cover the cost of a wheelchair. We have great FAQ content on Medicare-approved wheelchairs and mobility scooters that should help you understand the approval process. If covered, it would fall under Part B, leaving your mom responsible for the 20% coinsurance. However, if she has a Medigap plan, that coinsurance will be covered. The only out of pocket expense she might have to pay is the Part B deductible of $198 unless she has Plan F. If she has Plan F, that deductible would also be covered. Hopefully, this helps! Don’t hesitate to reach out with any more questions.

  7. The walker that I’ve been approved for sits too low and has small wheels. The supplier said I have no choices but that one !! Is there any way to chose and pay the difference ?

    1. Hi Donna! This is a tough one. If you’re renting the equipment, Medicare makes monthly payments for use of the equipment to the supplier. So, that may be why they don’t want to take the walker back. Ideally, if they do not have the appropriate size walker for you, they should take it back. Then you and/or your doctor would find another supplier near you that does have the appropriate size walker for your needs. Have you talked to your doctor about this issue? I would recommend you call your doctor that prescribed your walker. You can also call 1-800-MEDICARE to find out how to replace your walker. Between Medicare & your doctor, you should be able to get this issue resolved.

  8. Hello, I have a patient here that have a medicare health insurance part A and part B. Asking if she have any DME coverage. What are the steps she needs to do to get all information and process to get DME?

    1. Hi Lady! Yes, if your patient has Part B, then she has coverage for DME. Part B will cover 80% of her DME costs. The other 20% will be her responsibility to pay unless she has a Medigap plan to cover it. To get the process started for DME, she would need to speak to her doctor to get a prescription for the DME.

  9. My mother in law who has Alzheimer’s is currently in a long term care facility in Norfolk, VA, and is being charged $2700.00 per month for a wound vac. Can this be right? My husband is being stonewalled by the facility and Medicare says he needs a Guardianship to speak to them. He is the caregiver, has POA, and is trustee over her financial decisions. Please help!! My mother in law has Medicare Part A, Part B, and Federal BCBS as 2ndary! Need advice!

    1. Hi Cindy! I’m so sorry you’re going through this with your mother-in-law. There is a difference between POA & Guardianship. If Medicare is stating you need guardianship, then that’s what I would recommend you do. A wound vac is considered Durable Medicare Equipment and should be covered 80% under Part B as long as her doctor deems it’s medically necessary. The remaining would be billed to her Federal BCBS plan.

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