Medicare Information regarding your Medical Equipment

Tuesday, July 10, 2018
image description

From Medicare.gov

Medicare Part B covers some equipment, known as durable medical equipment (DME) that helps you complete your daily activities. Medicare usually covers DME if the equipment:

  • Is durable, meaning it is able to withstand repeated use
  • Serves a medical purpose
  • Is appropriate for use in the home, although you can also use it outside the home
  • And, is likely to last for three years or more.

To be covered by Medicare Part B, DME must be prescribed by your doctor or primary care provider (PCP). If you are in a skilled nursing facility (SNF) or are a hospital inpatient, DME is covered by Part A.

Whether you have Original Medicare or a Medicare Advantage Plan, the types of Medicare-covered equipment should be the same. Examples of DME include

  • Wheelchairs
  • Walkers
  • Hospital beds
  • Power scooters
  • Portable oxygen equipment
  • Orthotics
  • Prosthetics
  • Certain diabetes supplies

Medicare also covers certain prescription medication and supplies that you use with your DME, even if they are disposable or can only be used once. For example, Medicare covers medications used with nebulizers. Medicare also covers lancets and test strips used with diabetes self-testing equipment.

There are certain kinds of equipment that Medicare does not cover, including the following:

  • Equipment mainly intended to help you outside the home. For example, if you can walk on your own for short distances—enough to get you around inside your house—Medicare does not cover a motorized scooter that you only need outside the home.
  • Most items intended only to make things more convenient or comfortable. This includes stairway elevators, grab bars, air conditioners, and bathtub and toilet seats.
  • Items that are thrown away after use or that are not used with equipment. For example, Medicare does not cover incontinence pads, catheters, surgical facemasks, or compression leggings. However, if you receive home health care, Medicare pays for some disposable supplies—including intravenous supplies, gauze, and catheters—as part of your home health care benefit.
    • Note: catheters may be covered as prosthetics if you have a permanent condition.
  • Modifications to your home, such as ramps or widened doors for improving wheelchair access
  • Equipment that is not suitable for use in the home. This includes some types of DME used in hospitals or skilled nursing facilities (SNFs) like paraffin bath units and oscillating beds.

In order to have your DME covered, you will need to get a prescription or order from your doctor or PCP, and you will need to get your DME from the right kind of supplier.

To find out if Medicare covers the equipment or supplies that you need, or to find a DME supplier in your area, call 1-800-MEDICARE or visit www.medicare.gov. You can also learn more about the Medicare coverage of DME by contacting your State Health Insurance Assistance Program (SHIP). If you do not know how to contact your SHIP, you can call 877-839-2675 or visit www.shiptacenter.org.