Paying for DME: What Is DME? Will My Insurance Cover It?
People are living longer lives. Since 2019, Americans older than 65 have outnumbered those younger than five.
One reason for this longevity is technology. Doctors and manufacturers are working together to create tools that preserve people's health. An important tool is durable medical equipment (DME).
What is DME? What are the most common types of it? How do Medicare and private insurers cover it?
Answer these questions and you can live a happy life inside your home. Here is your quick guide.
What Is Durable Medical Equipment?
Durable medical equipment is medical equipment used in the home setting. It is any tool that helps a person function inside their home with minimal support from others.
As the name suggests, DME must be re-usable and versatile. A person must use it on a regular basis, preferably every day.
Wheelchairs are standard examples of DME. Other forms include walkers, handrails, and blood monitors.
Home medical supplies are not DME. They are single-use items like diabetes test strips. Some medical professionals use the term "assistive technology" to refer to durable medical equipment.
Does Medicare Cover DME?
Medicare covers many forms of DME, but they have some specifications. You must receive a prescription from your primary care provider. The equipment must serve a medical purpose, like assisting your mobility.
Original Medicare and Medicare Advantage plans cover wheelchairs, walkers, and scooters. If you live in a skilled nursing facility, Part A covers your equipment expenses.
Does Medical Insurance Cover It?
If you are under a private plan, you may receive coverage. The government does not require private insurers to cover DME. You need to examine the terms of your plan to see if it does.
Many plans that do cover DME limit what receives coverage. They may require you to buy your equipment from an approved supplier. Most maintain databases of suppliers on their public-facing websites.
Others may not make a mandate, but they have preferred brands. If you buy from a non-preferred one, you may face higher rates or fees. Whenever possible, you should buy from a preferred brand.
You can keep potential costs down by renting equipment instead of buying it. You may be able to rent a hospital bed. Talk to your doctor to see if this is an option for you.
So What Is DME?
People have a lot of questions when they are preparing for home health care. What is DME?
It is versatile and long-lasting medical equipment that bolsters the quality of life. Wheelchairs and scooters count alongside hospital beds and glucose monitors.
Does Medicare cover it? Both Original Medicare and Medicare Advantage do. But a patient must have a prescription for it.
Does private insurance cover it? Each package varies, but most cover wheelchairs and mobility devices.
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