Understanding Your Medicare DME Benefits
Durable medical equipment (DME) is equipment or supplies that are ordered by a health care provider for extended use to improve the quality of life at home or safety. DME includes temporary hospital-grade equipment, mobility devices, and long-term use safety or medically-necessary items. Examples of DME include hospital beds, oxygen equipment, CPAP, wheelchairs, glucometers, and commodes, among other things.
At Perkins Medical Supply, we sell, rent, and repair durable medical equipment and other medical supplies for the residents of Florida. We understand that your independence, health, and well-being depend on your access to quality medical equipment, and we want to supply exactly what you need. Our skilled staff can help you navigate the complex world of medical equipment and your insurance benefits. Join us today as we offer a brief overview of Medicare and DME.
DME Under Medicare
Medicare defines durable medical equipment as medically necessary equipment that is prescribed by your provider. Medicare Part B coverage will pay for DME as long as it meets these requirements:
- Must be durable — able to withstand repeated use.
- Medically necessary and used for a medical reason.
- Not typically useful to someone who isn’t sick or injured.
- Used in the home.
- Has an expected lifespan of at least 3 years.
- Must have documentation of a Face-to-Face office visit with a physician.
Medicare requires that both the prescribing provider and the DME supplier be enrolled in Medicare to cover the equipment costs. In some cases, Medicare may require you to pay 20% of the Medicare-approved amount with a deductible and any difference that the supplier charges. For some equipment or situations, you may need to rent or buy the equipment.
DME Medicare Covers
Generally speaking, Medicare will cover any DME that your provider prescribes that is medically necessary. Commonly covered DME includes:
- Glucometers and test strips
- Commode chairs
- Continuous passive motion (CPM) devices
- Continuous positive airway pressure (CPAP) devices
- Hospital beds
- Infusion pumps and supplies
- Oxygen equipment and accessories
- Nebulizers and medications
- Pressure-reducing mattresses
- Suction pumps
- Traction equipment
- Wheelchairs and scooters
If you have been prescribed DME, it is wise to contact Medicare to double-check that it will be covered and what your out-of-pocket expense may be. At medical supply companies like Perkins Medical Supply, you will be presented with several options so you can make the best choice for your situation.
What Medicare Does Not Cover
There are certain types of DME that your provider may prescribe that Medicare does not cover. Some of these examples include:
- Equipment that is meant for use outside the home.
- Equipment that is meant for convenience or comfort without serving a medical need — stairway lifts, grab bars, shower chairs, etc.
- Disposable medical supplies — incontinence supplies, compression stockings, etc.
- Home modifications — wheelchair ramps or widening of doorways.
At Perkins Medical Supply, we have four locations in Florida and can ship nationwide. Contact one of our friendly and helpful associates to get the answers to your questions and get the equipment you need. We work with most major medical insurance providers and offer the option to buy, rent, or work with your insurance carrier. Contact us today!