Quick Answer
Yes, Medicare Part B covers durable medical equipment (DME) when it is medically necessary, ordered by a physician, and supplied by a Medicare-enrolled supplier. You generally pay 20% of the Medicare-approved amount after your $283 annual Part B deductible. A Medigap plan can cover this 20% coinsurance.
Coverage Comparison by Plan Type
| Plan Type | Coverage | Notes |
|---|---|---|
| Wheelchairs & Scooters | Covered | Manual and power wheelchairs covered when medically necessary |
| Walkers & Canes | Covered | Covered when prescribed by a physician |
| CPAP Machines | Covered | Covered for diagnosed sleep apnea; initial rental period applies |
| Hospital Beds | Covered | Covered for home use when medically necessary |
| Oxygen Equipment | Covered | Covered for diagnosed chronic conditions requiring supplemental oxygen |
| Blood Sugar Monitors | Covered | Covered for diabetic beneficiaries; test strips included |
| Comfort/Convenience Items | Not Covered | Items primarily for comfort rather than medical necessity are excluded |
Understanding Your Coverage Options
Medicare Part B - DME Coverage Requirements
Covered at 80% - you pay 20% coinsuranceMedicare Part B covers durable medical equipment when four criteria are met: (1) the equipment is medically necessary, (2) a physician orders it, (3) the equipment is used in your home, and (4) the supplier is enrolled in Medicare.
**What counts as durable medical equipment?** Medicare defines DME as equipment that can withstand repeated use, is primarily medical in nature, is not useful to someone who is not sick or injured, and is used in the home.
Medicare covers DME on either a purchase or rental basis depending on the item. Most items are rented initially, and Medicare may purchase the item after a rental period. For capped rental items (like CPAP machines), Medicare rents for 13 months and then ownership transfers to you.
What It Covers
- Wheelchairs (manual and power) and scooters
- Walkers, canes, and crutches
- CPAP and BiPAP machines for sleep apnea
- Hospital beds for home use
- Oxygen equipment and supplies
- Blood glucose monitors and test strips
- Nebulizers for respiratory conditions
- Prosthetic limbs and orthotics
- Infusion pumps
- Traction equipment
What It Doesn't Cover
- Items primarily for comfort or convenience
- Equipment not ordered by a physician
- Equipment from non-Medicare-enrolled suppliers
- Items used outside the home
- Grab bars and bathroom safety equipment (generally not covered)
You pay 20% of the Medicare-approved amount after the $283 annual Part B deductible. A Medigap plan can cover this 20%, making most DME effectively free.
Use a Medicare-Enrolled Supplier
You must get your DME from a supplier enrolled in Medicare to receive coverage. If you use a non-enrolled supplier, Medicare will not pay - and you may be responsible for the full cost. Ask your supplier to confirm they accept Medicare assignment before ordering.
Competitive Bidding and DMEPOS
Competitive bidding applies in many areasMedicare uses a Competitive Bidding Program for certain DME items in many parts of the country. Under this program, Medicare contracts with specific suppliers who offer the lowest prices for quality equipment. If you live in a competitive bidding area, you must use a contracted supplier to get Medicare coverage for those items.
The Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) program covers a broad range of items. Your physician's order and supporting documentation (such as a sleep study for CPAP) are required to establish medical necessity.
What It Covers
- All standard DME items when ordered through a participating supplier
- Replacement supplies (CPAP masks, tubing, filters; test strips)
What It Doesn't Cover
- Items from non-contracted suppliers in competitive bidding areas
✦ Frequently Asked Questions
Jagger Esch
AuthorJagger Esch is the Medicare Educator at MedicareFAQ and the founder of Elite Insurance Partners.
Ashlee Zareczny
ReviewerAshlee Zareczny is a licensed Medicare agent in all 50 states dedicated to educating those eligible for Medicare.