Durable medical equipment (DME) is equipment that helps you complete your daily activities. It includes a variety of items, such as walkers, wheelchairs, and oxygen tanks. Medicare usually covers DME if the equipment is:
- Durable, meaning you can use it again;
- Designed to help a medical condition or injury;
- Suitable to use in the home, although you can also use it outside the home; and
- Likely to last for three years or more.
Medicare will only cover the cost of your DME if your doctor prescribes it and certifies that you need it to get around your home, not just to get around outside of your home.
The cost of your DME and the rules you must follow vary depending on your area and what DME you need. If you have Original Medicare, it will usually cover 80 percent of the cost of your DME and you or your supplemental insurance will be responsible for the remaining 20 percent. This applies to providers who accept assignment, or the Medicare amount as payment in full. If you go to a provider who doesn’t accept assignment, you may have to pay more. Call 800-Medicare or go towww.medicare.gov/supplier to find out your cost and the rules you must follow.
If you have a Medicare Advantage plan, each plan sets its own rates. Contact your plan to find out your cost and the rules you must follow.