How Medicare Covers Durable Medical Equipment

What counts as DME

Equipment generally must withstand repeated use, serve a medical purpose, usually be useful primarily to someone who is ill or injured, be used in the home, and be expected to last at least three years.

Common examples

Covered items may include walkers, wheelchairs, hospital beds, oxygen equipment, CPAP equipment, glucose monitors, canes, and other qualifying supplies.

Rental versus purchase

Depending on the equipment, Medicare may require rental, purchase, or offer a choice. Ask who owns the equipment, who handles maintenance, and what happens if coverage or suppliers change.

Confirm the supplier

Confirm that both the prescriber and supplier are enrolled in Medicare. In Original Medicare, ask whether the supplier accepts assignment; a nonparticipating supplier may charge more. For Medicare Advantage, use the plan’s supplier network and confirm any authorization before delivery. Get the expected rental or purchase terms in writing.

Before ordering equipment

• Use information for the correct plan year and service area.

• Confirm important details directly with the plan, provider, employer, or supplier.

• Keep copies of notices, confirmations, and cost estimates.

• Ask the prescriber for medical-necessity documentation and the supplier for written rental, purchase, repair, and replacement terms.

Medicare’s current DME rules

Review Medicare’s current DME coverage guidance and supplier directory. Coverage for repairs, replacement, oxygen, CPAP, and competitive-bidding items can have additional rules. Keep the prescription, medical-necessity records, delivery receipt, and notices in case a claim needs review or appeal.

Educational information only; not legal, tax, medical, or financial advice.

Compare coverage for the equipment you need

Gala Health can help you compare how represented plans handle DME networks, authorization, assignment, and expected member costs.