Durable Medical Equipment

WHAT IS DURABLE MEDICAL EQUIPMENT?

Durable Medical Equipment (or DME) refers to medical equipment that your doctor prescribes for use in your home. Under Medicare guidelines, DME must meet the following criteria:

• It must be durable (long-lasting)
• It must be used for a medical reason
• Not useful to somebody who isn’t injured or sick
• Is used in the home

WHAT KINDS OF EQUIPMENT WOULD I NEED IN MY HOME?

DME may include:

• Air-fluidized beds – An air-fluidized bed uses warm air under pressure to set small ceramic beads in motion which simulate the movement of fluid. When a patient is placed in this type of bed, body weight is evenly distributed over a large surface area which creates the sensation of “floating.”
• Blood sugar monitors and diabetic testing strips
• Canes
• Commode chairs
• Continuous Positive Airway Pressure (CPAP) machine – These are used to help people with sleep apnea obstructions breathe more easily during sleep. A CPAP machine increases air pressure in the throat so that the airway doesn’t collapse when inhaling.
• Crutches
• Home oxygen equipment – Length of rental coverage through Medicare varies. Be sure to verify what your coverage will be based on your doctor’s prescription.
• Hospital beds
• Infusion Pumps
• Nebulizers
• Patient lifts – These are necessary to lift patients from bed or wheelchair by hydraulic operation – Medicare may only cover the cost of the most basic model.
• Scooters
• Suction pumps
• Traction equipment
• Walkers

DOES MEDICARE COVER DME?

For most equipment there are specific criteria that must be met. Typically, you will be responsible to pay 20% of the Medicare-approved amount. Depending on the equipment, Medicare may allow the equipment to be rented, purchased, or you may choose to buy or rent. As a rule, Medicare pays for most durable medical equipment on a rental basis. Your doctor and supplier must also be enrolled in Medicare.

Take some time to learn how Medicare pays for the DME you require. Some items will have “capped rentals.” A capped rental means that Medicare will pay for the rental of equipment for 13 continuous months at which time coverage will stop. The rules for renting oxygen are different, so it’s important to ask your supplier for details. Also be aware that Medicare will only help pay for the most basic version of equipment. If you are interested in equipment with upgraded features or more advanced models, you will most likely have to pay more money out-of-pocket.

It’s also important to know that Medicare does NOT cover any bathroom safety equipment such as shower chairs, transfer benches, grab bars, raised toilet seats, etc. Medicare coverage stops at the bathroom door.

IS IT BETTER TO RENT OR OWN DURABLE MEDICAL EQUIPMENT?

The decision to rent or buy durable medical equipment really depends on what equipment you need and what Medicare will cover. Medicare may only give you purchase options on certain items.

If you are in a private pay situation, you need to evaluate the length of time you will need the equipment and the complexity of the equipment which may dictate constant maintenance.

A walker is a much simpler piece of equipment versus a patient lift which has many mechanical parts. When you rent equipment, you are not responsible for having to pay for costly repairs, especially if you expect to be using it for an indefinite period of time.

Our expert staff can make sure you have all of the information you need and can guide you to the best DME suppliers in South Florida. Don’t be afraid to call today and ask for guidance!