Quick Answer
Medicare Part B covers durable medical equipment (DME) that is medically necessary, prescribed by a doctor, and suitable for home use. You pay 20% coinsurance after the Part B deductible ($257 in 2026). Equipment must be purchased from a Medicare-enrolled supplier.
Coverage Comparison by Plan Type
| Plan Type | Coverage | Notes |
|---|---|---|
| Original Medicare (Part B) | 80% of approved amount | 20% coinsurance after $257 deductible; must use enrolled supplier |
| Medicare Advantage | At least equal to Original Medicare | May require prior authorization; copays vary by plan |
| Medigap Plan G | Covers the 20% coinsurance | Works with Original Medicare only; $0 after deductible |
| Medicaid (Dual Eligible) | Covers Medicare's 20% coinsurance | $0 for most dual eligibles; state-specific rules apply |
Understanding Your Coverage Options
What Qualifies as DME?
Durable medical equipment must meet four criteria to be covered by Medicare: it must be durable (able to withstand repeated use), primarily medical in nature, appropriate for home use, and medically necessary as prescribed by a doctor.
What It Covers
- Must be durable (can withstand repeated use)
- Must be primarily medical in nature (not for comfort or convenience)
- Must be appropriate for home use
- Must be medically necessary and prescribed by a doctor
- Examples: wheelchairs, walkers, hospital beds, CPAP machines, oxygen equipment, blood glucose monitors
What It Doesn't Cover
- Items that are primarily for comfort (e.g., air conditioners, ordinary mattresses)
- Equipment used only in a medical facility
- Items not prescribed by a physician
- Equipment from non-Medicare-enrolled suppliers
Common DME Items Medicare Covers
Medicare Part B covers a wide range of durable medical equipment when medically necessary. Common covered items include mobility aids, respiratory equipment, and diabetes supplies.
What It Covers
- Wheelchairs and power scooters (mobility impairment required)
- Walkers, crutches, and canes
- Hospital beds for home use
- CPAP and BiPAP machines for sleep apnea
- Oxygen equipment and supplies
- Blood glucose monitors and test strips (diabetes)
- Continuous glucose monitors (CGMs) - expanded 2023
- Nebulizer machines for respiratory conditions
- Prosthetics and orthotics
- Therapeutic shoes for diabetics (1 pair per year)
What It Doesn't Cover
- Hearing aids (not covered under Original Medicare)
- Eyeglasses (except after cataract surgery)
- Bathroom safety devices (grab bars, raised toilet seats)
- Stair lifts and home modifications
- LASIK surgery equipment
Rent vs. Buy
Medicare may pay to rent or buy DME depending on the item. For expensive items like power wheelchairs, Medicare often pays to rent for 13 months, after which ownership transfers to you.
How to Get DME Covered
To get DME covered by Medicare, you need a written prescription from your doctor, documentation of medical necessity, and you must use a Medicare-enrolled supplier.
What It Covers
- Step 1: Get a written order (prescription) from your doctor
- Step 2: Ensure your doctor documents medical necessity in your records
- Step 3: Use a Medicare-enrolled DME supplier (check Medicare.gov/supplier-directory)
- Step 4: Confirm the supplier accepts Medicare assignment
- Step 5: Pay the 20% coinsurance after the $257 Part B deductible
What It Doesn't Cover
- Suppliers not enrolled in Medicare cannot bill Medicare
- Items purchased before a doctor's order is written
- Equipment not documented as medically necessary
Competitive Bidding Program
CMS runs a competitive bidding program for common DME items in certain geographic areas. In these areas, you must use a contract supplier for covered items like CPAP machines, oxygen, walkers, and wheelchairs.
What It Covers
- CMS runs a competitive bidding program for common DME items in certain areas
- Winning suppliers offer lower prices to Medicare
- Covered items include CPAP, oxygen, walkers, wheelchairs, and more
- In competitive bidding areas, you must use a contract supplier
- Outside bidding areas, any Medicare-enrolled supplier may be used
What It Doesn't Cover
- Custom items (custom wheelchairs, prosthetics) are not subject to competitive bidding
- Rural areas may have different supplier requirements
2026 DME Cost Examples
| Equipment | Medicare Pays | You Pay (20%) | Notes |
|---|---|---|---|
| Standard wheelchair | 80% of approved amount | ~$150–$300 | After $257 deductible |
| Power wheelchair | 80% of approved amount | ~$500–$1,500 | Prior auth often required |
| CPAP machine | 80% of approved amount | ~$60–$150 | Rental for 13 months, then own |
| Oxygen equipment | 80% of approved amount | ~$40–$80/month | Rental; capped at 36 months |
| Blood glucose monitor | 80% of approved amount | ~$10–$30 | Test strips also covered |
| CGM | 80% of approved amount | ~$50–$150/month | Expanded coverage since 2023 |
| Hospital bed | 80% of approved amount | ~$100–$300 | Rental or purchase |
| Walker | 80% of approved amount | ~$20–$60 | Standard or wheeled |
✦ Important Exceptions
Advance Beneficiary Notice (ABN)
If your supplier thinks Medicare may not cover an item, they must give you an ABN before providing it. You can choose to get the item and pay out-of-pocket, or decline.
Medicare Advantage and DME
MA plans must cover the same DME as Original Medicare, but may require prior authorization, use of specific suppliers, or different cost-sharing.
Medigap and DME Costs
Medigap Plan G and Plan F cover the 20% Part B coinsurance for DME, leaving you with $0 after the annual deductible.
Therapeutic Shoes for Diabetics
Medicare covers one pair of therapeutic shoes (or inserts) per year for people with diabetes. This is a separate benefit from standard DME.
✦ 2025–2026 Legislative Updates
CGM Coverage Expansion (2023)
PassedCMS expanded coverage of continuous glucose monitors to all Medicare beneficiaries with diabetes who need insulin or are at risk of hypoglycemia.
Part B Deductible Increased to $257
PassedThe 2026 Part B deductible increased from $240 to $257, affecting the amount you pay before Medicare covers 80% of DME costs.
Competitive Bidding round 2024
PassedCMS updated competitive bidding contracts for common DME items, potentially changing which suppliers are contracted in your area.
DME Coverage Checklist
DME Coverage Checklist
- Get a written prescription from your doctor before ordering any DME
- Verify your supplier is enrolled in Medicare (Medicare.gov/supplier-directory)
- Ask if the supplier accepts Medicare assignment to limit your costs
- Check if you're in a competitive bidding area - you may be required to use a contract supplier
- Consider Medigap Plan G to cover the 20% coinsurance
- If denied, file an appeal - many DME denials are overturned on appeal
- Keep all documentation of medical necessity for your records
✦ Frequently Asked Questions
David Haass
AuthorDavid Haass is a licensed Medicare insurance agent and content contributor at MedicareFAQ.
Ashlee Zareczny
ReviewerAshlee Zareczny is a licensed Medicare agent dedicated to helping those eligible for Medicare find the best coverage options.