Durable Medical Equipment Covered by Medicare


Medicare will cover many pieces of Durable Medical Equipment. Part B will include most medical equipment you may need. Coverage can include prescriptions that may accompany equipment, like medications with a nebulizer. Equipment is essential for so many because it can help with daily tasks. Let’s take a look at the Durable Medical Equipment Medicare will cover and discuss the guidelines for coverage. Then, we can answer some common questions on the topic.

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Medicare Guidelines for Durable Medical Equipment

Part B will cover Durable Medical Equipment you’ll use at your home if your doctor decides you need it. Medicare won’t cover all devices, but it does include a good majority. You’ll be able to use the Durable Medical Equipment in your home or a long-term care facility. If you have to stay in a skilled nursing facility, the facility will provide you with your equipment. Part A covers skilled nursing facilities, so your devices will be covered, inpatient too.

Eligibility Criteria for Medicare to Cover Durable Medical Equipment

  • Endure repeated use
  • Serve a medical purpose
  • Must be appropriate for home use

What Equipment Does Medicare Pay For?

Medicare covers the following durable medical equipment.

What DME is Not Covered By Medicare?

While Medicare covers a wide range of medical equipment, it doesn’t cover everything.

Some supplies and equipment that aren’t covered can include:

  • Equipment to help you outside your home
  • Equipment intended only to make things convenient and comfortable—for example, stairway elevators, air conditioners, and toilet seats
  • Disposable items. For example, Medicare won’t cover incontinence pads, catheters, facemasks, or compression stockings
  • Changes to your home. Modifications may include ramps or broader doors for wheelchair access
  • Equipment not suitable for use in your home

Purchasing vs. Renting Durable Medical Equipment Through Medicare

Durable Medical Equipment can end up being quite expensive. You may find equipment available for purchase or rental.  In most cases, Medicare pays to rent medical equipment. But Medicare will buy some equipment that’s inexpensive like a walker or cane.

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Medicare usually will help with any repairs or replacements you may need for your device. Sometimes you need the equipment longer than a few months. Medicare may buy equipment rather than renting for situations like these.

Criteria for Medicare to Cover a Replacement for Durable Medical Equipment

  • Lost
  • Stolen
  • There’s extensive damage.
  • If it’s more than five years old

To ensure coverage, you’ll need to order from an equipment supplier who’s Medicare-approved.

Durable Medical Equipment Suppliers Approved by Medicare

To get coverage for equipment, you’ll need to get your supplies from a Medicare-approved supplier.  You can check Medicare’s website to be sure that you find a qualifying supplier.

Does Medicare Advantage Cover Durable Medical Equipment?

Medicare Advantage plans must offer the same level of coverage through Medicare. But, often, you’ll find many more perks with an Advantage plan such as extra coverage.

Advantage plans come from private insurance companies. You’ll want to confirm with your plan to ensure your equipment has coverage.

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FAQs

Does Medicare cover walkers?
Part B benefits will cover walkers as long as your walker is medically necessary, and you have a prescription from the doctor.
Does Medicare cover Hoyer lift?
 Hoyer lifts are a brand of patient lifts for those with mobility difficulties. Part B will either rent or buy the equipment. Medicare will cover ten months of your rental if you end up renting a lift. After your rent for ten months, you’ll get the option to buy the lift. If you decide to buy your lift after ten months, Medicare will pay for three more payments before you own the lift. If you don’t want to buy the lift, Medicare will pay a total of 15 monthly payments. After 15 months, you’ll have to start paying the rental fee. Hoyer lifts cost an average of $1,000, so insurance is crucial to keeping costs down.
Does Medicare cover gloves?
Part B will cover rubber gloves as long as they’re for use with patients with ESRD. Medicare won’t include any disposable latex or nitrile gloves.
Is the UPWalker covered by Medicare?
Durable Medicare Equipment suppliers must accept Medicare and the UPWalker suppliers do NOT accept Medicare, so even with a prescription, Medicare won’t cover the UPWalker. Simply because the supplier won’t accept Medicare as payment.
Does Medicare cover walkers with seats?
Medicare will cover the cost of walkers intended for use inside the home. Part B covers a portion of the cost for these when they’re medically necessary.

How to Find Medicare Coverage for Durable Medicare Equipment

You may have questions or concerns about your Medicare coverage for Durable Medical Equipment. Medigap policies can help you with the costs of DME items you may need. Our agents can answer any coverage questions you may have. We can also look at different plans that may better suit your needs. Call us today for a quote. Our services are free to you! You can also compare rates online today.

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Jagger Esch

Jagger Esch is the Medicare expert for MedicareFAQ and the founder, president, and CEO of Elite Insurance Partners and MedicareFAQ.com. Since the inception of his first company in 2012, he has been dedicated to helping those eligible for Medicare by providing them with resources to educate themselves on all their Medicare options. He is featured in many publications as well as writes regularly for other expert columns regarding Medicare.

24 thoughts on “Durable Medical Equipment Covered by Medicare

  1. My mother in law who has Alzheimer’s is currently in a long term care facility in Norfolk, VA, and is being charged $2700.00 per month for a wound vac. Can this be right? My husband is being stonewalled by the facility and Medicare says he needs a Guardianship to speak to them. He is the caregiver, has POA, and is trustee over her financial decisions. Please help!! My mother in law has Medicare Part A, Part B, and Federal BCBS as 2ndary! Need advice!

    1. Hi Cindy! I’m so sorry you’re going through this with your mother-in-law. There is a difference between POA & Guardianship. If Medicare is stating you need guardianship, then that’s what I would recommend you do. A wound vac is considered Durable Medicare Equipment and should be covered 80% under Part B as long as her doctor deems it’s medically necessary. The remaining would be billed to her Federal BCBS plan.

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