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Durable Medical Equipment Covered by Medicare


Durable medical equipment is essential for so many Medicare beneficiaries because it can help with many daily tasks. In this article, we will look at the durable medical equipment Medicare will cover and discuss the guidelines for coverage. Then, we will answer some common questions on whether Medicare helps cover durable medical equipment costs.

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Medicare Guidelines for Durable Medical Equipment

Durable medical equipment may be covered under Original Medicare, which comprises of Medicare Part A and Medicare Part B.

Common examples of durable medical equipment include:

  • Wheelchair
  • Crutches
  • Walker
  • Nebulizer
  • Ventilators
  • Heart rate monitor

Medicare Part A covers skilled nursing facilities and inpatient care. So, inpatient devices are covered by Medicare Part A. Medicare Part B will cover Durable Medical Equipment you use at your home if your doctor decides it is medically necessary for you. The durable medical equipment must come with a prescription from a licensed health professional to be covered.

Medicare won’t cover all durable medical equipment, but it does include several items.

You’ll be able to use durable medical equipment in your home or a long-term care facility. If you must stay in a skilled nursing facility, the facility will provide you with your equipment. Medicare Part A covers skilled nursing facilities, so inpatient devices are covered.

Eligibility Criteria for Medicare to Cover Durable Medical Equipment

To qualify for Medicare coverage of durable medical equipment, there is specific criteria Medicare requires you to meet in addition to being ordered by a Medicare-approved doctor and using a Medicare accepting supplier.

To be covered by Medicare Part B, a durable medical equipment device must be:

  • Used because of illness or injury
  • Used at home
  • Likely to last for at least three years
  • Endure repeated use
  • Serve a medical purpose

What Durable Medical Equipment Does Medicare Cover?

Original Medicare does not cover all durable medical equipment. Beneficiaries only receive coverage if the device is medically necessary. If you require a durable medical equipment that is not covered by Medicare, you may have to pay the full cost of the device.

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Original Medicare covers the following durable medical equipment:

The list above is not all-encompassing. So, it is important to speak with your doctor before purchasing a device.

What Durable Medical Equipment is Not Covered By Medicare?

While Original 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, 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. Often, Medicare pays to rent medical equipment and buy equipment when necessary.

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

To ensure Medicare coverage for replacement medical equipment, you need to order from an equipment supplier who’s Medicare-approved. Medicare will not cover a replacement just because you wish to have a new device. There are certain criteria that will warrant a replacement device to be covered by Medicare. These include:

  • Lost
  • Stolen
  • There’s extensive damage.
  • If it’s more than five years old

Durable Medical Equipment Suppliers Approved by Medicare

When you need access to durable medical equipment, you may find it hard to know where to start and what durable medical equipment supplies are available to help you with your needs.

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You’ll need to get your supplies from a Medicare-approved supplier to get coverage for equipment. Medicare.gov has a durable medical equipment supplier directory to help Medicare beneficiaries search for suppliers that carry Medicare-covered equipment and supplies.

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 a Medicare Advantage plan, such as extra coverage.

Medicare Advantage plans come from private insurance companies. You’ll want to confirm with your plan to ensure your equipment has coverage.

Medicare Durable Medical Equipment FAQs

Does Medicare cover walkers?
Medicare 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. Medicare Part B will either rent or buy the equipment. Medicare will cover ten months of your rental if you rent 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 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?
Medicare Part B will cover rubber gloves under certain circumstances. Medicare won’t include any disposable latex or nitrile gloves.
Does Medicare cover UpWalker?
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. Medicare 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 durable medical equipment items you may need. Our licensed Medicare agents can help answer any questions you may have regarding Medicare coverage of durable medical equipment. We can also look at different coverage options 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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Sources:

MedicareFAQ is dedicated to providing you with authentic and trustworthy Medicare information. We have strict sourcing guidelines and work diligently to serve our readers with accurate and up-to-date content.

  1. Durable Medical Equipment Coverage, Medicare.gov. Accessed May 2022.
    https://www.medicare.gov/coverage/durable-medical-equipment-dme-coverage
  2. Medicare Coverage of DME and Other Services, CMS. Accessed May 2022.
    https://www.medicare.gov/Pubs/pdf/11045-medicare-coverage-of-dme.pdf

Jagger Esch

Jagger Esch is the Medicare expert for MedicareFAQ and the founder, president, and CEO of Elite Insurance Partners and MedicareFAQ.com. Since the inception of his first company in 2012, he has been dedicated to helping those eligible for Medicare by providing them with resources to educate themselves on all their Medicare options. He is featured in many publications as well as writes regularly for other expert columns regarding Medicare.

26 thoughts on “Durable Medical Equipment Covered by Medicare

  1. 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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