In many cases, Medicare will offer assistance in covering the cost of durable medical equipment through Part A and Part B benefits. Private pay insurance coverage for durable medical equipment varies widely depending on medical need and your insurance plan. Durable medical equipment offers greater independence through the help of technology based products that help lift, support, or aid in a person's mobility.
On occasion individuals encounter an injury or illness that causes them to experience increased weakness. Whether it is difficulty in walking, getting up from a seated position or standing long enough to take a shower, durable medical equipment can go a long way toward improving the safety and independence of those who live in their own homes.
For more information contact your local DME provider
How can I get Medicare coverage for DME?
You must have your doctor prescribe the equipment for you and certify that it is medically necessary in order to get Medicare coverage. Your doctor must complete the DME Medical Necessity form. You may obtain this form from your physician or from your local Medicare office. This form must be submitted to Medicare along with your DME claim. DME suppliers, rather than the beneficiaries, must submit the claims paperwork to Medicare.
How much will Medicare pay?
Medicare determines the maximum rate it will consider for payment for each piece of DME, known as the “approved amount.” Medicare then pays 80 percent of that approved amount. Will Medicare pay for the DME all at once? Medicare will not pay for the purchase of DME valued at over $150 all at once. Instead, Medicare makes monthly rental payments during the period of medical need. These payments usually equal 10 percent of the purchase price of the DME and may not exceed a period of 15 months. After 15 months of continuous rental, a beneficiary is considered to own the equipment.