Home Care and Hospice - Durable Medical Equipment & Supplies
Durable medical equipment (DME), also known as DMEPOS (Durable Medical Equipment, Prosthetics, Orthotics, and Supplies) is equipment that primarily serves a medical purpose, is able to withstand repeated use, and is appropriate for use in the home.
The most commonly prescribed examples include wheelchairs, oxygen equipment, hospital beds, pressure mattresses, lift beds, bili lights and blankets. Mobility aids such as walkers, scooters, canes, crutches and wheelchairs. Personal care aids such as bath chairs, commodes, dressing aids.
Under the durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) category, Medicare Part B also covers:
- Prosthetic devices that replace all or part of an internal bodily organ
- Prosthetics, like artificial legs, arms, and eyes
- Orthotics, like rigid or semi-rigid leg, arm, back, and neck braces
- Certain medical supplies
Medicare also covers certain prescription medications and supplies that you use with your DME, even if they are disposable or can only be used once. For example, Medicare covers medications used with nebulizers. Medicare also covers lancets and test strips used with diabetes self-testing equipment.
If insurance is to cover the cost, the equipment must be prescribed by your primary care provider (PCP) for use in your home as medically necessary. Many of the items are covered by Medicare Part B. However, if you are in a skilled nursing facility (SNF) or are a hospital inpatient, DME is covered by Part A.
To qualify for Medicare reimbursement, a DME vendor must be accredited by a professional entity such as The Joint Commission or the Community Health Accreditation Program.
Please note, there are certain kinds of durable medical equipment (DME) and supplies that Medicare does not cover
, including the following:
- Equipment mainly intended to help you outside the home. For example, if you can walk on your own for short distances–enough to get around your house–Medicare does not cover a motorized scooter that you only need outside the home.
- Most items intended only to make things more convenient or comfortable. This includes stairway elevators, grab bars, air conditioners, and bathtub and toilet seats.
- Items that get thrown away after use or that are not used with equipment. For example, Medicare does not cover incontinence pads, catheters, surgical facemasks, or compression leggings. However, if you receive home health care, Medicare pays for some disposable supplies–including intravenous supplies, gauze, and catheters–as part of your home health care benefit. Note: Catheters may be covered as prosthetics if you have a permanent condition.
- Modifications to your home, such as ramps or widened doors for improving wheelchair access.
- Equipment that is not suitable for use in the home. This includes some types of DME used in hospitals or skilled nursing facilities (SNFs), like paraffin bath units and oscillating beds.
- Keep in mind that Medicaid may cover some forms of equipment that Medicare will not cover.
To find out if Medicare covers the equipment or supplies you need, or to find a DME supplier in your area, call 1-800-MEDICARE or visit www.medicare.gov. You can also learn about Medicare coverage of DME by contacting your State Health Insurance Assistance Program (SHIP).
Click here to find approved suppliers in your area through Medicare. Enter your ZIP code to find suppliers in your area. Your homecare or hospice agency also may be able to help you find a DME provider.