As we move closer to 2023, Medicare is the premier health insurance program for most seniors in the United States. With its comprehensive coverage for medical and health care needs, Medicare helps to ensure that those aged 65 and over have access to the essential medical services they need.
Medicare is made up of several distinct "parts." Part A, known as hospitalization insurance, is designed to provide comprehensive coverage for inpatient care. Part B sometimes referred to as major medical, is for various types of outpatient care, like laboratory tests, doctor's office visits, and even Durable Medical Equipment (DME). DME is an assortment of medical equipment or supplies necessary for the patient's appropriate care as an outpatient. For the patient to benefit from this coverage, their condition and the type of equipment or supplies must be suitable.
If your doctor has determined it's medically necessary, Medicare Part B may cover the DME you need for home use. To be eligible for this coverage, you'll need a prescription and the proper documentation from a Medicare-approved healthcare provider. Furthermore, Medicare Part B can also cover DME used in long-term care facilities and relatives' homes.
Part B coverage requires a DME device or supply to be medically necessary due to an illness or injury, properly documented and intended for use in a residential setting - not just for comfort or convenience.
Uncover the many types of medical equipment that may be covered under Durable Medical Equipment (DME)! From wheelchairs to oxygen tanks, discover the wide range of eligible items. Here are some of the most common DME options:
Wheelchairs and Scooters
Medicare Part B (Medical Insurance) is here to help you get the power-operated scooter or manual wheelchair your doctor has prescribed for you in your home. To qualify for financial support, you'll need a face-to-face examination and written prescription from your doctor or treating provider. Part B will only cover the cost of a power wheelchair if it's medically necessary for you.
Oxygen Equipment and Supplies
Medicare can help you get the oxygen equipment and accessories you need for home use if your doctor prescribes them as durable medical equipment. Your coverage will include oxygen, the necessary contents, and supplies for its delivery as long as all conditions are met.
- A severe lung disease diagnosis has left your oxygen levels dangerously low. - Oxygen therapy may be the solution you need to restore your health. - Your arterial blood gas readings suggest that successful treatment is within reach, even if other treatments have not worked.
If you meet the criteria listed above, Medicare can assist you with covering your costs of oxygen-supplying systems, oxygen-storing containers, and the tubing and accessories necessary for oxygen delivery and measurement.
Your oxygen machine could qualify for Medicare coverage to provide you with a humidifier, making breathing easier and more comfortable!
Continuous Positive Airway Pressure (CPAP) Equipment
If you've been diagnosed with obstructive sleep apnea, you may be eligible for Medicare coverage of CPAP therapy and accessories for up to 3 months. Once the trial period is over, Medicare could continue to cover the therapy and related items if your doctor can demonstrate in your medical records that it's helping you and you meet the necessary criteria.
Diabetic Test Supplies
Medicare Part B helps to provide long-term support for those with diabetes by offering a wide range of diabetic test supplies, including blood glucose (blood sugar) test strips, as durable medical equipment (DME).
Nebulizers & Nebulizer Supplies
Part B of Medicare coverage allows you to get durable medical equipment (DME) such as a nebulizer and certain medicines used with it, all prescribed by your doctor for use in the comfort of your home.
Infusion Pumps and Supplies
Part B of Medicare offers coverage for infusion pumps, plus certain medications used with them if they're determined to be necessary and reasonable. Your doctor will prescribe them so that you can access this helpful medical device.
Your Costs
Once you have satisfied your Part B Deductible, you will only need to pay 20% of the Medicare-Approved Amount if your supplier agrees to the assignment.
If your doctors and DME suppliers meet Medicare's rigorous qualifications, they can join Medicare and receive payments for the claims they submit. On the other hand, if they don't meet the standards, Medicare won't cover your DME expenses.
It's essential to make sure your doctors and DME suppliers are enrolled in Medicare - ask them to confirm if they accept Medicare so you can take advantage of only paying the coinsurance and Part B deductible for the Medicare-approved amount. Otherwise, you could be faced with no limit on how much a supplier can charge you if they are not participating in Medicare.