Does Medicare Cover Durable Medical Equipment?

Medicare Part B Covers Durable Medical Equipment When It's Medically Necessary

Yes, Medicare covers durable medical equipment (DME), equipment such as wheelchairs, walkers, hospital beds, and oxygen supplies that your doctor prescribes for use in your home. Medicare Part B, the portion of Original Medicare that covers outpatient services and supplies, pays 80% of the Medicare-approved amount for DME once you've met your annual Part B deductible, according to Medicare.gov. You're responsible for the remaining 20% coinsurance, and you must get the equipment from a supplier enrolled in Medicare.

Not every item labeled "medical equipment" qualifies. Medicare has specific rules about what counts as DME, who can prescribe it, and which suppliers you can use to keep your costs predictable.

Quick Answer

Medicare Part B covers durable medical equipment, including wheelchairs, walkers, hospital beds, oxygen equipment, and CPAP machines, when a doctor prescribes it as medically necessary for use in your home. You pay 20% coinsurance after meeting your annual Part B deductible, and you must use a Medicare-enrolled supplier that accepts assignment. Medicare Advantage plans must cover the same DME, but often through their own supplier networks.

What Qualifies as Durable Medical Equipment

Medicare defines DME as equipment that's durable (built to withstand repeated use), primarily serves a medical purpose, isn't useful to someone who isn't sick or injured, and is appropriate for use in the home. Your doctor or other treating provider must prescribe it as medically necessary for your specific condition.

Items Medicare Part B typically covers include:

Wheelchairs, walkers, and canes
Hospital beds for home use
Oxygen equipment and accessories
Continuous positive airway pressure (CPAP) machines and supplies
Blood sugar monitors and test strips
Nebulizers and the medications they use
Patient lifts and commode chairs

Medicare generally does not cover items meant for comfort or convenience rather than treatment, such as grab bars, stairlifts, or air conditioners, even if your doctor recommends them. It also excludes most disposable supplies unless they're tied directly to a covered piece of equipment, such as CPAP filters or ostomy supplies.

What You Pay for Covered DME

80%

Share Medicare Part B pays after you meet your annual deductible

20%

Your coinsurance for Medicare-approved DME

How to Make Sure Your Equipment Is Covered

Coverage depends on more than medical necessity. You also need to use a supplier enrolled in Medicare, and for many items, that supplier must "accept assignment," meaning they agree to charge only the Medicare-approved amount. If you use a supplier that doesn't accept assignment, you could pay significantly more out of pocket, and Medicare may not reimburse you at all if the supplier isn't enrolled.

Some equipment falls under the Medicare DMEPOS Competitive Bidding Program, which contracts with specific suppliers in certain areas for items like walkers, oxygen equipment, and hospital beds. If you live in one of these areas, using a non-contracted supplier can mean Medicare pays nothing toward the equipment, according to the Centers for Medicare & Medicaid Services (CMS), the federal agency that administers Medicare.

Whether Medicare covers your equipment as a rental or a purchase depends on the item. Wheelchairs and hospital beds are often rented over a set period, after which ownership can transfer to you, while less expensive items like walkers and canes are typically purchased outright.

Steps to Get DME Covered by Medicare

Get a written order from your doctor stating the equipment is medically necessary

Confirm your supplier is enrolled in Medicare and accepts assignment

Ask whether the item requires prior authorization before you receive it

Check whether the DMEPOS Competitive Bidding Program applies in your area

Keep copies of your prescription and supplier paperwork for your records

Typically Covered

Wheelchairs, walkers, and canes prescribed for home use
Home oxygen equipment and supplies
Hospital beds ordered for a documented medical condition
CPAP machines and related supplies for diagnosed sleep apnea
Blood sugar monitors and diabetic testing supplies

Typically Not Covered

Home modifications like grab bars, ramps, or stairlifts
Equipment used mainly for comfort or convenience rather than treatment
Items purchased from a supplier that isn't enrolled in Medicare
Disposable supplies not tied to a covered piece of equipment
Equipment intended for use outside your home, such as at a vacation property

Prior Authorization May Apply

Medicare requires prior authorization for certain DME items, including some power wheelchairs and other high-cost equipment, before it will pay a claim. Ask your supplier to confirm whether your item needs prior authorization; skipping this step can leave you responsible for the full cost, according to CMS.

Medicare Advantage Plans Must Cover DME Too, but Rules Vary

If you're enrolled in a Medicare Advantage plan instead of Original Medicare, your plan is required to cover at least the same DME that Medicare Part B coverage includes, but the plan can set its own network of approved suppliers and may require prior authorization even for items Original Medicare doesn't flag. Check your plan's supplier directory before you order equipment, since using an out-of-network supplier can mean higher costs or no coverage at all.

DME needs often overlap with other coverage questions. If you're recovering after a hospital stay, see how equipment coverage compares with skilled nursing facility care coverage, or review what Medicare covers for home health care if you're also receiving nursing or therapy visits at home. If you're still working and covered by a group health plan, confirm how Medicare and employer coverage coordinate before you order equipment, and if you're new to Medicare, review how Medicare and Social Security enrollment timing affects when your Part B coverage, including DME, begins. Frequent travelers should also weigh how Medicare Advantage vs. Medigap plans handle equipment needs away from home.

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Frequently Asked Questions

Medicare Part B covers a replacement CPAP machine if your current equipment reaches the end of its useful lifetime, typically around five years, or if your medical needs change, as long as your doctor documents continued medical necessity.

Medicare Part B generally covers repairs to equipment you own when the repair costs less than replacing the item, as long as the equipment is still medically necessary and wasn't damaged through misuse.

You can appeal the decision through your plan's formal appeals process. Your plan's denial notice will explain the specific steps and deadlines for filing an appeal.

While you're in a Medicare-covered skilled nursing facility stay, the facility, not Part B, is generally responsible for supplying necessary equipment, since it's included in the facility's bundled payment.