Durable Medical Equipment & Medicare

Durable Medical Equipment & Medicare

Medicare Does Cover Certain Durable Medical Equipment

Medicare covers certain durable medical equipment, also known as DME, as prescribed by your healthcare physician. All recipients of Medicare are eligible for durable medical equipment coverage. According to Medicare.gov, the equipment must meet the following criteria in order to be covered by your plan:

  • Equipment must be used inside the home
  • Equipment must be long-lasting and durable
  • Equipment must be prescribed by a physician for a medical reason
  • Equipment must be useful to someone who is injured or sick

How Much Will You Pay for Durable Medical Equipment?
Even with Medicare coverage, patients will still be responsible for 20% of the cost of the durable medical equipment. Medicare will only cover the equipment if a supplier or doctor is enrolled in the Medicare program. If the supplier does not accept “assignment,” the supplier can charge any amount for the equipment and will not be limited in the amount that they can charge you by Medicare. An assignment is an agreement by your doctor, the supplier, etc. to collect payment for the equipment from Medicare. If you are purchasing or renting from a supplier that is not enrolled in Medicare and will not accept payment from Medicare, you will be responsible for paying the entire bill for the DME.

Medicare Does Cover Certain Durable Medical Equipment

How does the Competitive Bidding Program Work?
Medicare has recently established a competitive bidding program that is active in the following states: Ohio, California, Florida, Pennsylvania, North Carolina, South Carolina, Missouri, Kansas, Indiana and Texas. The competitive bidding program will be expanded in July of 2013, and more states will be added to the existing list of territories operating through the Competitive Bidding Program.

This program was instituted to limit the amount that Medicare pays for certain DME’s, orthotics, prosthetics, etc. and provides a list of suppliers that are approved for Medicare recipients to purchase or rent these items. Medicare will only pay for durable medical equipment through contract suppliers, like Owens Healthcare, that offer affordable prices on the medical equipment, which saves you and Medicare money in the long run. The equipment provided by these suppliers is also rigorously inspected to ensure that you are purchasing high quality medical equipment from suppliers that you can trust.

The following is a list of equipment that Medicare covers under most circumstances; however, there may be other equipment that is not listed here that will be covered. Check with your doctor, or with the team at Owens Healthcare, to see if the equipment that you need is covered under your Medicare plan.

  • Air-fluidized beds
  • Home oxygen equipment and supplies
  • Infusion pumps
  • Diabetic testing strips and blood sugar monitors
  • Hospital beds
  • Certain canes to help with mobility
  • Continuous Positive Airway Pressure (CPAP) machine
  • Nebulizers
  • Commode chairs
  • Wheelchairs and walkers
  • Patient lifts
  • Traction equipment
  • Suction pumps
  • Crutches