Do you want to learn about equipment rentals that insurance covers?
“My dad refused to move his bedroom and bathroom from the second floor of his home.
One day this choice was made for him. Fortunately, the rehabilitation specialist introduced him to medical equipment so that he could remain safe at home.”
Healthcare has been transformed by the rapidly changing furniture, devices, and gadgets we know as Durable Medical Equipment (DME). Today it is possible to set up an entire hospital room at home thus reducing the anxiety of illness and recovery in unfamiliar surroundings.
DME categories include:
- Mobility – walkers, canes, crutches, knee walkers, rollators, and mobility accessories
- Bath Safety – bath benches, bath accessories, transfer benches, elevated toilet seats, grab bars, safe-t-poles, and commodes
- Wheelchairs – narrow, basic, extra-wide, antimicrobial, bariatric, pediatric, recliner, hybrid, translator, transport, and cushions and accessories
- Hospital Beds – MedLite, basic, simplicity, bariatric, bed accessories, mattresses, side rails, trapeze bars, and overbed tables
- Patient Handling – bath lift, stand assists, floor lifts, slings, lifts and vests, gait pacers, patient safety devices, transfer board, transfer sheets, and stretchers
- Patient Safety Alarms – pressure-sensing safety, pull cords, wireless, talking, and specialty alarms
- Therapy – Resistive exercise, Tens units, pain relief, exercise balls and mats, exercisers, instant packs, ice bags, activities of daily living products and tools
Medicare Part B
Covers the care you receive outside the hospital or nursing home care. This pays for outpatient and therapy care, doctor’s visits, prevention care like vaccinations and DME. Here is a list of the most common DME covered when prescribed by a physician as ‘medically necessary and within the limits of Medicare’s approved vendors:
- Blood sugar monitors
- Blood sugar test strips
- Commode chairs
- Continuous passive motion devices
- Continuous Positive Airway Pressure (CPAP) devices
- Hospital beds
- Infusion pumps & supplies
- Lancet devices & lancets
- Nebulizers & nebulizer medications
- Oxygen equipment & accessories
- Patient lifts
- Pressure-reducing support surfaces
- Suction pumps
- Traction equipment
- Wheelchairs & scooters
Medicare Part C
Is commonly known as Medicare Advantage. These plans are purchased through insurance companies. They cover the items listed here for Parts A & B and Part D. Each Medicare Advantage plan sets up their benefits profile and cost paid by members depending on the local market where they are selling the plans. Some of these plans now offer vision, hearing, and dental coverage (which regular Medicare does not). Medicare Advantage covers DME like Medicare Part B and sometimes beyond. Medicare Advantage plans offer benefits to address social needs as well as medical.
How to select the right DME
- Focus on the actual tasks your loved one wants or needs to do when choosing devices. While this might seem obvious, it’s easy to get drawn into buying a product that looks good but doesn’t really address your loved one’s needs.
- For example, if someone does not have difficulty remembering to take their medications but gets confused about which pills to take at which times, a weekly pill organizer that can be filled by a caregiver or a pre-filled subscription service would solve the problem. Purchasing an automated pill dispenser with alarms to remind the person to take medications would be more complicated than necessary and would certainly be more expensive than the simpler pill organizer. Generally, it is best to pick the simplest product available to meet the need. Simpler devices are often easier to use, less expensive, and easier to repair and maintain than more complex devices are.
- Ask other people with disabilities what products they have found to be helpful.
- Ask experts who provide care to your loved one, like rehabilitation specialists, occupational therapists, and physical therapists about which type of technology might be best.
- Ask to use the device on a trial basis to see if it is truly going to meet your loved one’s needs.
- Ultimately, your loved one’s opinion about a certain piece of DME is the most important. The device needs to be comfortable, attractive, and simple to use.
Understanding insurance reimbursement for medical devices can be tricky. We recommend that you consult your insurance handbook for more information on coverage.
Here are some resources to check out: