Durable Medical Equipment
The definition of durable medical equipmentCertain equipment, like a walker, wheelchair, or hospital bed, that’s ordered by your doctor for use in the home. can vary from insurance provider to provider. You will need to talk to your healthcare provider and insurance provider to confirm what can be prescribed, what can be covered, and what you may have to pay for yourself. Durable medical equipment is equipment that your doctor orders for use in the home, including:
- Bath transfer chairs
- Adjustable or pressure-reducing beds, mattresses, and covers
- Bed rails
- Bedside commodes
- Continuous Passive Motion Devices
- Continuous Positive Airward Pressure Devices
- Diabetic blood testing strips
- Diabetic blood sugar monitor
- Grab bars
- Hospital beds
- Infusion pumps and supplies
- Lancet devices and lancets
- Bed and chair lifts
- Mobility scooters
- Nebulizers and nebulizer medication
- Oxygen equipment and accessories
- Safety rails
- Seat cushion
- Shower chairs/stools
- Standing support
- Suction pumps
- Traction equipment
- Transfer chairs or boards
- Walkers with wheels or a seat
- Wheel chairs
Paying for Durable Medical Equipment
MedicareThe federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant).
Medicare Part BCovers certain doctors’ services, outpatient care, medical supplies, and preventive services. may cover durable medical equipmentCertain equipment, like a walker, wheelchair, or hospital bed, that’s ordered by your doctor for use in the home. that your doctor prescribes for home use. Visit Medicare’s Durable Medical Equipment coverage page to see what items are covered and how Medicare determines what is covered.
Medicare will only work with certain suppliers. Visit Medicare’s Medical Equipment and Suppliers page to search for a supplier by zip code. Make sure to double-check with the supplier and Medicare before you buy or rent any equipment.
MedicaidA joint federal and state program that helps with medical costs for some people with limited income and resources.
Medicaid Fee-for-Service will cover hearing aids and other durable medical equipment (for example, oxygen equipment, wheelchairs, blood test strips).
Medicaid Managed CareA health care delivery system that combines health insurance, delivery of care, and administration. Managed Care Organizations (MCOs) are paid a set payment per member per month for these services. plans may also cover these things if they are “medically necessaryThis refers to care or equipment that your doctor has prescribed to treat an illness or condition.,” meaning that your doctor prescribes them to treat an illness or injury. To find out what your health plan will cover, call the Member Services number on the back of your health insuranceA type of insurance that pays for some or all of your medical expenses.
card, or review your Member HandbookThe handbook you receive when you sign up for a health insurance plan. It includes information on what providers are in your network, what benefits are covered, and how much they will cost. .
Private Health Insurance, Including Marketplace Plans
Marketplace plans may cover some Durable Medical equipment, although you may have to pay a copaymentAn amount you may be required to pay for a medical service or supply, like a doctor’s visit or prescription drug. A copayment is usually a set amount, like $10 or $20. Also called a copay. or coinsuranceThe percentage of the total cost of a healthcare service that you must pay after you have met your deductible.. Plans will cover at least some of the cost as long as the equipment is “medically necessary,” meaning that your doctor has prescribed it to treat an illness or injury. To find out what your health plan will cover, call the Member Services number on the back of your health insurance card, or review your Member Handbook.
More Help with Durable Medical Equipment
Adelante Development is a nonprofit organization based in Albuquerque, New Mexico that recycles used medical equipment through its BackInUse program, although it is not a Durable Medical Supplier. If you are in need of medical equipment and do not have insurance or need equipment not covered by your insurer, you can call them at (505) 445-5332 for a new request.