What Counts as Durable Medical Equipment (DME)
Medicare covers durable medical equipment under Part B (medical insurance). To qualify as DME, the equipment must meet all of the following criteria:
- Durable: It can withstand repeated use and has a lifespan of at least 3 years.
- Medical Purpose: It is used to treat or manage a medical condition — not purely for comfort or convenience.
- Home Use: It is primarily used in the home setting, including an assisted living facility if that is your permanent residence.
- Medically Necessary: It must be prescribed by a healthcare provider who certifies it’s needed for your condition.
- Not Useful to a Healthy Person: The item is designed specifically for someone who is sick, injured, or disabled.
If an item meets all these conditions, it is generally considered DME and may be eligible for Medicare coverage.
Common Types of Medicare-Approved Equipment
Medicare Part B covers a wide range of durable medical equipment, including but not limited to:
Mobility Aids
- Manual and power wheelchairs
- Walkers, rollators, and canes
- Scooters (with prior authorization)
- Crutches and commode chairs
Explore More:
See our wheelchair offerings
See our range of mobility aids
Home Care Equipment
- Hospital beds and patient lifts
- Pressure-reducing mattresses
- Bedside commodes
- Trapeze bars
Respiratory and Sleep Equipment
- Oxygen tanks and concentrators
- Nebulizers and supplies
- CPAP and BiPAP machines for sleep apnea
Diabetes Supplies
- Blood glucose monitors and test strips
- Continuous glucose monitoring (CGM) systems
- Lancet devices and related accessories
Explore More:
Learn more about our diabetic footwear solutions
Orthotics and Prosthetics
- Braces (arm, leg, back, and neck)
- Artificial limbs
- Breast prostheses after mastectomy
- Ostomy bags and related supplies
Explore More:
See our braces and orthotic solutions
Infusion and Feeding Equipment
- Infusion pumps and related tubing
- Enteral nutrition pumps and supplies
What You’ll Pay Under Medicare
If the supplier is Medicare-approved and accepts assignment, you’ll typically pay:
- 20% coinsurance of the Medicare-approved amount
- Part B deductible (applies once per year)
From there, Medicare pays the remaining 80%.
Some equipment is rented instead of purchased. For example:
- Wheelchairs or hospital beds are often rented for up to 13 months.
- Oxygen equipment is typically rented for up to 36 months, with the supplier responsible for maintenance during that time.
Once the rental period is complete, you may own the equipment, depending on the item type.
What Medicare Does Not Cover
Certain items and modifications do not qualify as DME, including:
- Disposable supplies (bandages, diapers, gloves, wound dressings)
- Equipment for convenience or comfort (air purifiers, humidifiers, hot tubs, massagers)
- Home modifications (stair lifts, grab bars, ramps)
- Items used outside the home unless medically justified
However, some Medicare Advantage (Part C) plans may offer additional benefits that cover home safety or convenience items not included in Original Medicare.
Learn more about our insurance and Medicare coverage.
Equipment Coverage — Step-by-Step
1. Doctor’s Prescription
Your doctor must confirm the item is medically necessary and provide a written order to the supplier.
2. Use a Medicare-Approved Supplier
The supplier must be enrolled with Medicare and accept assignment.
You can verify this using the Medicare Supplier Directory.
3. Prior Authorization
Certain items, such as power wheelchairs, need prior approval before Medicare will pay.
4. Receive and Learn to Use Your Equipment
The supplier delivers and sets up your equipment and explains how to use it safely.
5. Understand Repair and Replacement Policies
If equipment breaks, Medicare Part B generally covers 80% of the repair costs.
Replacement is usually allowed after the item’s useful lifetime (about five years), or sooner if medically necessary.
For Californians with Medi-Cal or Dual Eligibility
If you have both Medicare and Medi-Cal (known as “dual eligible”), special rules apply:
- Medicare pays first, and Medi-Cal may cover any costs that Medicare does not.
- Medi-Cal’s DME coverage can be broader — including equipment used outside the home, such as in school or community settings.
- Under California’s Charpentier v. Belshe ruling, Medi-Cal must process DME requests without waiting for Medicare authorization, helping patients access equipment faster.
Avoiding Fraud and Overbilling
AARP warns patients to stay cautious:
- Be skeptical of unsolicited calls or “free equipment” offers.
- Only order through your doctor or a trusted supplier.
- Review your Medicare Summary Notice (MSN) to confirm only approved items were billed.
- Report suspicious activity to 1-800-MEDICARE.
Key Takeaways
- Medicare Part B covers DME that is durable, medically necessary, prescribed by a doctor, and used at home.
- You pay 20% of the approved cost (after the deductible) when using a Medicare-approved supplier.
- Not all supplies are covered, such as disposable or comfort-based items.
- Dual eligible individuals (Medicare + Medi-Cal) have additional protections and coverage options in California.
- Always verify your supplier, ask about rental vs. purchase terms, and keep your documentation.
Final Thoughts
Durable medical equipment can be life-changing — from helping you move safely to improving sleep or breathing. Knowing exactly what Medicare covers, and how to qualify, ensures you receive the right care without unnecessary costs or delays.
If you’re unsure whether a specific item qualifies, talk with your healthcare provider or contact Medicare directly at 1-800-MEDICARE for up-to-date coverage details.
If you’re unsure whether a specific item qualifies, talk with your healthcare provider or contact Feroz Medical Supplies today for expert guidance.
