Not all types of DME are covered by Medicare. If a device is designed for use outside the home, it’s likely you can’t cover it through Medicare. Also, if a piece of equipment is for convenience or comfort, Medicare typically does not cover it.
Items not covered by Medicare may include:2
- Modifications to the home, such as ramps
- Most disposable or single-use items
- Stair elevators
- Motorized scooters
- Air conditioners
- Toilet seats
- Grab bars
Eligibility criteria for DME Medicare coverage
To get your DME covered by Medicare, it must meet the following 2 conditions:
- First, your prescriber should issue a prescription or order for the device. Your healthcare provider must state in the document that you need the equipment to help with a medical condition and the equipment is for home use.
- Next, you must take your order or prescription to a Medicare-approved supplier to get the device covered.3
How can I get durable medical equipment?
You’ll have to use the right supplier for your DME if you want it covered. If you use Original Medicare, make sure your equipment supplier is Medicare-approved and takes assignment.4 Taking assignment means that the supplier agrees to Medicare’s approved amount for an item for payment.5
If you use Medicare Advantage, you’ll have to follow the rules of your insurance plan to get coverage. You may have to use a particular brand or shop within a network of suppliers. Rules may vary between plans, so make sure to check your plan or contact your insurance provider before buying equipment.4
Where to find Medicare coverage for durable medical equipment
Once you have a prescription or order for a device, you can get DME from Medicare-approved suppliers that take assignment. You can search for Medicare-approved suppliers near your ZIP code on the Medicare website.
Don’t be afraid to ask questions
Medicare doesn’t cover everything. If you have a healthcare need and you’re not sure if it’s covered, ask your doctor’s office to check for you.