Durable Medical Equipment
Durable medical equipment can greatly increase a person’s quality of life. Recently we have been getting questions about durable medical equipment and what is and is not covered by Medicare. In this article, we will discuss what equipment is considered durable medical equipment, how this equipment is covered by Medicare and the necessary steps to obtain this equipment through Medicare.
Medicare Part B provides coverage for durable medical equipment that is medically necessary and prescribed by a Medicare-enrolled doctor or healthcare provider for use in your home. Durable medical equipment refers to equipment that is durable, used for a medical reason, typically only useful to someone who is sick or injured, and expected to last at least three years.
Some of the durable medical equipment that Medicare covers includes blood sugar meters and test strips, canes, commode chairs, continuous passive motion machines, devices and accessories, continuous positive airway pressure (CPAP) machines, crutches, home infusion services, hospital beds, infusion pumps and supplies, lancet devices and lancets, nebulizers and nebulizer medications, oxygen equipment and accessories, patient lifts, pressure-reducing support surfaces, suction pumps, traction equipment, walkers, wheelchairs, and scooters.
After meeting the Part B deductible, you will pay 20% of the Medicare-approved amount if your supplier accepts assignment. Medicare pays for different kinds of durable medical equipment in different ways, and you may need to rent or buy the equipment, depending on the type of equipment. Medicare will only cover your durable medical equipment if your doctors and durable medical equipment suppliers are enrolled in Medicare and meet strict standards to enroll and stay enrolled in Medicare.
It is important to ensure that your doctors and durable medical equipment suppliers are enrolled in Medicare before getting durable medical equipment. If suppliers are participating in Medicare, they must accept assignment, meaning they can charge you only the coinsurance and Part B deductible for the Medicare-approved amount. If suppliers aren't participating and don't accept assignments, there is no limit on the amount they can charge you.
It is important to talk to your doctor or healthcare provider to find out how much your item will cost. The specific amount you'll owe may depend on several factors, such as other insurance you may have, how much your supplier charges, if your doctor accepts assignment, and where you get your item.
In summary, Medicare Part B provides coverage for durable medical equipment that is medically necessary and prescribed by a Medicare-enrolled doctor or healthcare provider. It is important to ensure that your doctors and durable medical equipment suppliers are enrolled in Medicare and meet strict standards to enroll and stay enrolled in Medicare. If you need durable medical equipment, talk to your doctor or healthcare provider to find out how much it will cost and whether you need to rent or buy the equipment.
