Durable Medical Equipment

At Home Senior Services is dedicated to giving seniors the care that they deserve.  We want to make sure our senior clients are aware of their potential coverage for durable medical equipment (DME) under the Medicare and Medicaid programs.  Read below to see if you qualify for Medicare or Medicaid to cover the durable medical equipment you need.

What is DME?

Durable medical equipment is any long-term, reusable device that provides therapeutic benefits to patients due to a medical condition, illness, or disability. In order for a device to qualify as a DME, they must primarily serve a medical purpose, be prescribed or ordered by a medical provider, can be used over and over again, be appropriate for home use, and will not be useful to patients without an injury, disability, or illness.

How Do I Pay for DME?

There are 5 primary methods of payment:

  1. Medicare Coverage: Covers around 80% of the cost
  2. Medicaid Coverage: Covers most or all expenses
  3. Veteran’s Benefits: Covers most or all expenses for veterans
  4. Private Insurance: Covers most of the cost
  5. Self-Pay: Out of the pocket of the patient

How do I request DME through Medicaid or Medicare?

  1. Potential candidates for DME should go to a physician to clarify their needs to their physician and inform the physician what coverage option he or she has before the prescription is written.
  2. The patient needs to find a supplier of the DME that is approved by their coverage provider (Medicaid or Medicare). Both providers have specific vendors that they approve to cover DME.
  3. If the patient cannot be covered by their provider, good places to get DME are online, medically supply stores, and even local grocery stores.

For more information on what durable medical equipment you can get through medicare and medicaid, visit www.medicare.gov or www.cms.gov.

Senior using durable medical equipment to stay at home with their child.

DME Requirements for Medicare

To qualify:

  • Have Medicare Part A or B
  • Doctor must prescribe equipment as medically necessary

Forms needed:

  • Chart notes, therapy notes, test results
  • If denied by Medicare, an Advanced Beneficiary Notice of Noncoverage

DME Requirements for Medicaid

To qualify:

  • Seniors 65 years or older of any income, disabled adults
  • Doctor must prescribe equipment as medically necessary

Forms needed:

  • Chart notes, therapy notes, test results
  • Prior Authorization

Do you need care?

Reach out to us and we will give you a call within 24 hours.