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Medicare Coverage of Medical Equipment

By Caring.com Staff

What It Is

Medical equipment (often called "durable medical equipment") rented or purchased for use in the patient's home

What's Covered

Medicare Part B covers a wide variety of medical equipment for use in a patient's home. Some equipment must be rented, some purchased, and sometimes the patient has a choice. Equipment must be medically necessary and prescribed by a doctor.

Covered equipment can include hospital or other special beds; patient lifts; commode chairs; canes, crutches, walkers, and wheelchairs (manual and power); oxygen equipment; traction equipment; infusion and suction pumps; nebulizers; blood sugar monitors; dialysis machines; and other equipment.

Medicare Part B doesn't cover equipment that's permanently installed in a patient's home, such as a ramp, special shower stall, bars, or railings.

If you have a Medicare Part C Medicare Advantage plan: Medicare Part C Medicare Advantage plans, also called Medicare Advantage plans, must cover everything that's included in original Medicare Part A and Part B coverage. But sometimes a Part C plan covers more, with extra services or an expanded amount of coverage. (Co-payments for Part C plans may also be different than those for Part A or Part B.) To find out whether your plan provides extra coverage or requires different co-payments for medical equipment, contact the plan directly.

What Medicare Pays

Medicare Part B pays 80 percent of the Medicare-approved amount for the rental or purchase of covered equipment. See special rules for wheelchairs and scooters.

Warning If covered equipment is rented or purchased from what's called a Medicare "participating supplier," the supplier can't charge more than the Medicare-approved amount for the item. However, a supplier who's enrolled in Medicare but isn't an officially "participating" supplier may charge more than the Medicare-approved amount. In that case, the patient must personally pay the difference between the Medicare-approved amount and the amount the supplier actually charges (on top of the 20 percent of the Medicare-approved amount that Medicare doesn't pay).

Important: Regardless of the rules regarding any particular type of care, in order for Medicare Part A, Medicare Part B, or a Medicare Part C plan to provide coverage, the care must meet two basic requirements:

  • The care must be "medically necessary." This means that it must be ordered or prescribed by a licensed physician or other authorized medical provider, and that Medicare (or a Medicare Part C plan) agrees that the care is necessary and proper. For help getting your care covered, see FAQ: How Can I Increase the Odds That Medicare Will Cover My Medical Service?

  • The care must be performed or delivered by a healthcare provider who participates in Medicare.