Your DME may at some point require repairs and/or maintenance from your supplier.
- Repairs by a supplier involve fixing equipment that is worn or damaged.
- Maintenance means checking, cleaning, and servicing your equipment.
If possible, you are expected to do regular maintenance yourself using the owner’s manual. However, a supplier should perform maintenance if the task is more complicated and requires a professional. Medicare’s coverage of more specialized DME repairs and maintenance depends on whether you or the supplier owns the equipment.
- Renting DME: As long as you are paying a monthly rental fee for your equipment, your supplier must perform all needed repairs and maintenance when a professional is required. The supplier cannot charge you for this work.
- Owning DME: If you purchased your equipment or otherwise own it, Medicare covers needed repairs and maintenance when a professional is required and the services are not covered by a warranty.
- Original Medicare covers 80% of the Medicare-approved amount when you use a DME supplier that takes assignment, or a contract provider in competitive bidding areas. You pay a 20% coinsurance.
- If you live in a competitive bidding area, it is most cost-effective to get repairs and maintenance done by contract suppliers. While Original Medicare covers maintenance and repair from any Medicare-approved supplier, contract suppliers must take assignment and so cannot charge you more than the Medicare-approved amount.
Note: There are separate rules for repairs and maintenance for oxygen equipment.
If you have a Medicare Advantage Plan, make sure to follow your plan’s coverage rules.
To find out if and how Medicare covers the DME repairs or maintenance you need, or to find DME suppliers in your area, call 1-800-MEDICARE or visit www.medicare.gov. You can also learn about Medicare coverage of DME by contacting your State Health Insurance Assistance Program (SHIP).