Medicare And Durable Medical Equipment

By Author: Suzanne Campbell
Total Articles: 36
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There are cases wherein a patient’s condition needs durable medical equipment (DME). Most of patients and their families worry about the costs of such equipment. However, their worries can be lessened if they know that Medical can cover some of these.

Before discussing the coverage, it would be best to define or enumerate first what these equipments are. Additionally, there are even qualifications that must be met by these medical apparatuses in order to meet the criteria of Medicare.

A simple definition of DME would be categories of equipment and supplies intended to be used by a patient or the recipient at home. The basic samples are walkers, wheelchairs, and hospital beds. Oxygen tanks and equipment are also included as well as diabetes self-test kits, nebulizers, and their medications. Scooters also qualify. However, extra requirements must be met for these and wheelchairs also.

There are also apparatuses outside this basic definition and are known as DMEPOS. This means aside from DME’s there are also prosthetics, orthotics, and other supplies related. Prosthetics is an artificial device ...
... extension that replaces missing or defective body parts. Under this device category are other familiar devices such as hearing aids, gastric bands, and dentures. On the other hand, orthotics is an orthopaedic device made to support or correct the function of a limb or torso. This group of apparatuses can also assist movements, speed up the rehabilitation of a patient with fractures after cast, and also reduce pain caused by a certain bone or joint condition.

Other Classifications of DMEs

Aside from the mentioned common samples of equipment, to be considered durable medical equipment and be covered by Medicare, devices must first be considered as affordable and regularly bought. Some are capped rented or purchased. There are also items that need recurrent and extensive servicing. Likewise, some nutrition devices and disposable devices are also included. As for the disposables, catheters are not counted but lancets and strips for diabetes are.

Medicare-Covered Equipment

Now, here are the requirements that must be met in order for Medicare to cover ME’s. First, it should be durable enough to endure frequent usage. Second, it should really be important to one’s medical needs. Third, this device must only be useful to the person if he has a condition or an injury. Meaning, there are no other way he can use it except if he has the related deficiency. Fourth, the apparatus must be suitable for home use and can be operated even by family members. Fifth, again, back on durability, the equipment should be functional at least 3 years or more. Lastly, the device must be bought from suppliers certified and approved by Medicare.

Furthermore, applicants who are under the care of a nursing home or a facility cannot expect coverage. This is because it is the facility’s responsibility to provide the needed devices.

Such rules for Medicare coverage are not the same in every state. This is why contacting Medicare or the state’s durable medical equipment department is highly suggested. This way it will be easier to inquire on classifications and coverage.