Medicare Part B covers durable medical equipment (DME), which is equipment that serves a medical purpose, is able to withstand repeated use, and is appropriate for use in the home. There are many important things to know about Medicare’s coverage rules for DME. Use the information below to learn whether/how you are covered.
- Eligible equipment: Medicare’s DME benefit does not cover all medical equipment. Learn the types of DME that Medicare pays for and about equipment and supplies excluded from Medicare coverage.
- Eligibility requirements: Medicare only covers DME if your provider says it is medically necessary for use in the home. You also must order your DME from suppliers who contract with Original Medicare or your Medicare Advantage Plan. Medicare Advantage Plans may have additional requirements you need to meet before your DME is covered. If you have Original Medicare, you may be affected by the competitive bidding demonstration.
- DME coverage: Depending on the type of equipment you need, Medicare requires that you either rent or buy DME. There are also special rules when you need oxygen equipment. Medicare typically only pays for standard equipment that meets your health needs. If you want special features or upgrades, you may have to pay more.
- Maintenance: The costs for maintenance and repair of your DME will depend on whether or not you rent or bought the equipment. Medicare may also cover replacement of the equipment.
Note: If Medicare denies coverage for your DME, you have the right to appeal the decision.