Medicare coverage of medical equipment

Medicare will cover certain types of medical equipment if it is:

• Able to withstand repeated use;
• Primarily and customarily used to serve a medical purpose;
• Generally not useful to a person in the absence of an illness or injury; and
• Appropriate for use in the home and
• Provided by specific suppliers that are approved by Medicare.

Some examples of this equipment are walkers, wheelchairs, power scooters, hospital beds, home oxygen equipment, diabetes self-testing equipment (and supplies) and certain nebulizers and their medications (non-disposable).

Sometimes, durable medical equipment is referred to as DMEPOS because Medicare also covers: prosthetics, orthotics and certain supplies (POS). Prosthetics are devices that can replace a missing body part, such as a hand or leg. Orthotics are equipment like braces that help to support or correct the malfunction of a limb or torso.

In most cases, Medicare does not cover medical supplies that generally are used and then thrown away.

An exception to this is that covers some medical supplies, like lancets and test strips for diabetes. Note: Some diabetes supplies are also covered under Part D.

Another exception is that if you qualify for Medicare home health, Medicare may cover certain disposable supplies, such as intravenous supplies, gauze or catheters.

To find out what items are NOT considered DME, click on the link in the GO TO box.

Medicare coverage of DME items can vary by state. For a specific question about Medicare coverage of DME, you can call your local durable medical equipment administrator. This is called the DME MAC, you can find the number of your local DME MACby calling 1-800-MEDICARE.

Starting January 1, 2011, in certain states Medicare will usually only cover certain durable medical equipment if you purchase it from a contract supplier. Contract suppliers are suppliers that have contracts with Medicare to provide certain DME in specific regions within the following states. The states are CA, FL, IN, KS, KY, MO, NC, OH, PA, SC and TX.

To find out more about your contract supplier, call Alpine at (801) 463-0044.

To find out what DME Medicare covers in your area, call 800-Medicare.