![]() ![]() If you still need oxygen therapy after 36 months, you no longer have to pay rental fees. You must still pay the 20 percent coinsurance each month. Medicare pays 80 percent of the rental fees for the oxygen and any supplies for 36 months. You can only rent this equipment, and supplier agreements are for a 5-year time frame. There are special rules for oxygen equipment. We’ll go over the reimbursement process later. If you choose to purchase equipment, you may have to pay the full amount and seek reimbursement from Medicare. In some cases, Medicare lets you decide if you want to rent or buy the equipment, for example, items that cost less than $150. If the equipment is made specifically to fit you, like a prosthetic, Medicare requires you to buy this type of product. Your supplier will let you know if the equipment will need to be returned. If you still need the equipment after this time, depending on the type of product, you may be allowed to own it. Original Medicare pays 80 percent of the monthly costs for 13 months of rental. A Medicare-approved supplier will know if you can buy an item. In general, most DME equipment is rented. You can also ask about coverage of specific items, costs, and any special requirements. You can contact the plan provider for a list of approved DME suppliers in your area. use separate suppliers for different types of equipment.require the use of in-network providers.Medicare Advantage (or Part C) plans have many of the same eligibility requirements, but there are some differences.ĭepending on the specific plan, Medicare Advantage plans may: Medicare requires you to go to approved healthcare providers and device suppliers for full coverage. There are different coverage rules for products like power mobility devices - including motorized wheelchairs or scooters - as well as some other DME products. Also, in-person visits must be within 6 months of the order for the DME product.ĭevices are not covered unless you have been injured or have a medical condition that requires therapeutic equipment. Your doctor may need to fill out a certificate of medical necessity for some DME products to be covered. Medicare Part B covers DME for home use when a doctor orders the equipment after a face-to-face visit. You are eligible for DME benefits if you are enrolled in original Medicare and meet certain other Medicare rules for coverage. What are the eligibility rules? Original Medicare rules In some cases, Medicare Advantage plans may cover more supplies than original Medicare, but you may have to meet a deductible before the plan pays for DME. Medicare Advantage plans must also cover at least the same DME products covered by original Medicare, but there may be specific restrictions. If you have original Medicare, your DME supplies for home use will be covered by Medicare Part B, as long as all eligibility requirements are met. For a full list of covered products, check Medicare’s DME coverage information here. continuous positive airway pressure (CPAP) devicesĭME coverage also includes orthotics, braces, prosthetics, and wound dressings.Every time you need new equipment, your doctor must provide a document stating its medical necessity for your condition. Medicare only pays for the basic level of DME products available for any given condition. They should also help you safely perform the activities of your daily life. In most cases, the covered equipment or device must be meant for repeated use and is not disposable like catheters (which are not covered).ĭME items are meant to help you manage a health condition, recover from an injury or illness, or recover from surgery. However, Medicare does consider these facilities your home when you live there long-term and will cover DME. Medicare does not cover DME during a short-term stay at a skilled nursing facility or hospital. ![]() Medicare defines DME as devices, supplies, or equipment that are medically necessary to maintain daily activities safely in the home. What does Medicare cover for medical devices? ![]()
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