Does Medicare cover medical equipment and supplies?

Kimberly Lankford,

AARP

Comments

En español

Published September 15, 2022

/ Updated August 02, 2024

In this story

DME defined • Eligible equipment • Your portion of the cost • Fraud tips

Yes. Medicare Part B covers prescribed equipment and supplies for home use that are considered medically necessary.

The key is that the materials must be categorized as durable medical equipment (DME), meaning they can withstand repeated use.

What DME will Medicare cover?

Medicare Part B covers doctor-prescribed, medically necessary equipment and supplies, such as:

Blood sugar meters and test strips
Commode chairs
Continuous glucose monitors
Continuous positive airway pressure (CPAP) machines
Hospital beds
Infusion pumps and supplies
Oxygen equipment and accessories
Walkers
Wheelchairs and scooters

Medicare also covers prosthetic and orthotic items, such as:

Arm, back, leg and neck braces
Artificial eyes and limbs
Breast prostheses following a mastectomy
Ostomy bags and related supplies for those who have had operations to control digestive or urinary tract diseases
Therapeutic devices, such as shoes or inserts for diabetics with foot problems
Urological supplies

What DME won’t Medicare cover?

Medicare won’t cover equipment and supplies you may need for medical reasons but are considered disposable, such as:

Compression socks
Incontinence pads
Rolled elastic bandages
Surgical face masks

Also likely to be rejected because they’re convenience items and not medically necessary are:

Air purifiers
Bathtub lifts
Raised toilet seats
Other home safety equipment

How does the equipment qualify for coverage?

To pass Medicare’s test for coverage, the equipment or supplies must be:

Considered medically necessary, not just convenient
Used in your home (a long-term care facility can qualify as your home)
Able to withstand repeated use and likely to last at least three years
Typically only useful to someone who is sick or injured
Prescribed by a doctor, nurse practitioner, physician assistant or other primary care professional
Provided by Medicare-approved suppliers

Some items, such as oxygen equipment and power wheelchairs, have additional requirements before Medicare will cover them. That could include getting prior authorization or renting instead of buying.

How much will I pay for the medical equipment?

If a medical equipment supplier accepts assignment, which means it agrees to take the Medicare-approved amount as payment in full, then Medicare Part B pays 80 percent of the cost of the equipment and supplies. You’ll pay the remaining 20 percent coinsurance.

If a supplier doesn’t accept assignment, it can charge whatever it wants for the equipment. Durable medical equipment doesn’t have a 15 percent limit on excess charges, which is something that exists for doctors and other health care providers who don’t accept assignment but have not opted out of Medicare.

Medigap helps. You can buy a private Medicare supplement policy to help cover Medicare’s deductibles, copayments and coinsurance. All Medigap policies cover the 20 percent Part B coinsurance either in part or in full.

Keep in mind

Medical equipment is often rented, but items are available for purchase. Requirements vary based on the equipment type.

Either way, you must get the equipment from a Medicare-approved supplier. Check out Medicare’s medical equipment supplier directory for approved suppliers in your area.

As you research and consider purchasing DME, beware of unsolicited calls or other communications offering “free” medical equipment, especially if they request your Medicare or Social Security number. It’s almost certainly a scam meant to steal your identity or a scheme to bill Medicare for devices that aren’t medically necessary and, oftentimes, never arrive.

It’s a good idea to review your Medicare summary notice (MSN) for suspicious charges. Medicare submits an MSN specifically for durable medical equipment that shows what claims Medicare received in your name over the past three months. Be sure to report to Medicare potentially fraudulent charges for items you didn’t order or receive.

Return to Medicare Q&A main page

%{postComment}%

Kimberly Lankford is a contributing writer who covers Medicare and personal finance. She wrote about insurance, Medicare, retirement and taxes for more than 20 years at Kiplinger’s Personal Finance and has written for The Washington Post and Boston Globe. She received the personal finance Best in Business award from the Society of American Business Editors and Writers and the New York State Society of CPAs’ excellence in financial journalism award for her guide to Medicare.