Medicare coverage of medical equipment

Question 1 of 14 (use "Last" or "Next" buttons to see more)

Medicare helps pay for certain kinds of medical equipment you may need. However, Medicare rules for coverage are strict and can be confusing. 

Use this section of Medicare Interactive to help you understand Medicare coverage of medical equipment and to learn how to get Medicare to pay for the items you need.   

Step 1: Find out what kinds of equipment Medicare does and does not cover and when.  Medicare only pays for medical equipment and supplies that are considered Durable Medical Equipment (DME). An item qualifies as DME if it is durable. This means that you can use it over and over. Also, the equipment must help you inside your home, not just outside it. For example, Medicare will help pay for a walker if you need it to get around inside your home, but not if you just need it outside the home.

Step 2: Learn what you need to do to get Medicare to pay for the DME you need. Medicare will only pay for durable medical equipment if your doctor says you need it. You must order the equipment from suppliers that Original Medicare or your Medicare Advantage plan have approved. If you have Original Medicare, what suppliers you must use will depend on whether Medicare’s competitive bidding program applies to you. 

Step 3: Learn how Medicare pays for DME.
Sometimes you must buy your DME from a supplier, but usually Medicare will pay for you to rent it. If you need oxygen, be aware that the rules for renting it are different. Also, be aware that Medicare will only help pay for the most basic version of equipment that will help you. If you want upgraded features or models, you usually need to pay more.

Step 4: Find out how Medicare covers maintenance, repairs and replacement of your equipment. Your costs for repairs and maintenance will depend on whether you rent or own the equipment. Medicare will pay to replace your current equipment but only if you meet certain requirements.

Step 5: Learn what you can do if Medicare has refused to pay for the DME you need. If Original Medicare or your Medicare Advantage plan refuses to pay after you have the equipment, you have the right to dispute the decision and try to get it changed. If you are confused or unhappy with competitive bidding in your area, call 800-Medicare to report those problems.


Related Questions
Can my state give me more rights and protections than federal law regarding Medigap plan enrollment?

Donate Now
 
 
Go to previous question Go to next question
 
GO TO
Types of medical equipment Medicare covers if you live at home

Types of home health care that Medicare will pay for

Medicare coverage of preventive care services

 
LINKS
Find a Medicare Durable Medical Equipment Supplier (Medicare.gov)

 
< Last | Next >