Whether you must buy or rent durable medical equipment (DME) is determined by the type of item you need. You must buy some items immediately. Generally, equipment that must be made to order, or that costs under $150 must be bought.
If you need oxygen equipment, you must rent it from a supplier. Other items, such as manual wheelchairs, must be rented first for a set period of time before you own them. With some items, you will have the option to buy or rent, such as with motorized wheelchairs. For more rules on how Medicare covers wheelchairs and motorized scooters, please click here.
A rented item (except for oxygen equipment) is referred to as a capped-rental item.
Your Medicare-enrolled supplier will know whether the DME you need must be bought or rented.
If you buy your equipment from a Medicare-enrolled provider, you will pay 20 percent of the Medicare-approved amount. You can save money if you go to a Medicare-enrolled supplier who accepts assignment.
If you rent equipment (except oxygen equipment), you are responsible for a monthly rental fee. This rental fee will be 20 percent of Medicare’s approved amount if you go to a Medicare-enrolled supplier who takes assignment.
After you rent a piece of equipment for 13 months, ownership will typically transfer to you. If you are renting oxygen equipment, Medicare will pay a monthly rental fee for up to 36 months. You pay 20 percent of the cost of the rental fee if your Medicare-approved supplier accepts assignment. After your 36-month rental period, you will no longer have to pay for oxygen equipment, but you will not own it. The supplier will still own the item and continue to be responsible for supplies and maintenance in most cases for two more years.
Starting January 1, 2011, if you live in (or are visiting when you need DME) certain regions in North Carolina, South Carolina, Ohio, Kentucky, Indiana, Texas, Missouri, Kansas, Florida Pennsylvania and California you must buy or rent your DME from contract providers. Contract suppliers have contracts with Medicare that permit them to provide DME services in their area. Contract suppliers are not allowed to charge you more than the amount Medicare approved in their contract.
If you rented your DME before January 1, 2011 and you live in a place where you must use a contract supplier, you should find out if your supplier is the contract supplier for that area. If your supplier is not the contract supplier, and you would like to continue using that supplier, they must agree to be grandfathered by Medicare. If the supplier does not agree to be grandfathered, you must switch to another supplier in order for Medicare to keep paying for your DME.