Medicare will only cover certain types of medical equipment. In order to be covered by Medicare, medical equipment must be:
- Able to withstand repeated use;
- Primarily and customarily used to serve a medical purpose;
- Generally not useful to a person in the absence of an illness or injury;
- Appropriate for use in the home ;
- Likely to last for 3 years or more;
- Provided by specific suppliers that are approved by Medicare; and
- Medically necessary for you.
Some examples of this equipment are walkers, wheelchairs, power scooters, hospital beds, home oxygen equipment, diabetes self-testing equipment (and supplies), certain nebulizers, and their medications (non-disposable). Additional rules apply for Medicare coverage of wheelchairs and scooters. Please click here for more information.
Sometimes, durable medical equipment is referred to as DMEPOS because Medicare also covers prosthetics, orthotics and certain supplies (POS). Prosthetics are devices that can replace a missing body part, such as a hand or leg. Orthotics are equipment like braces that help to support or correct the malfunction of a limb or torso.
In most cases, Medicare does not cover medical supplies like catheters that are generally used and thrown away. However, Medicare will cover certain medical supplies, like lancets and test strips for diabetes. Some diabetes supplies are also covered under Part D. Furthermore, if you qualify for Medicare home health, Medicare may cover certain disposable supplies, such as intravenous supplies, gauze or catheters.
Medicare coverage of DME items can vary by state. For a specific question about Medicare coverage of DME, you can call your local durable medical equipment administrator. This is called the DME MAC, you can find the number of your local DME MAC by calling 1-800-MEDICARE.
Starting January 1, 2011, in certain states Medicare will usually only cover certain durable medical equipment if you purchase it from a contract supplier. Contract suppliers are suppliers that have contracts with Medicare to provide certain DME in specific regions within the following states. The states are North Carolina, South Carolina, Ohio, Kentucky, Indiana, Texas, Missouri, Kansas, Florida Pennsylvania and California.