In addition to covering medical and hospital services, Medicare covers an array of medical equipment and supplies. In order for Medicare to pay for medical equipment, you must need to use it inside your home and it must be able to be used repeatedly. You must also follow Medicare’s coverage rules.
In brief, Medicare covers durable medical equipment so long as you need it to help you in your home with your health condition. It could be a wheelchair, a walker, a crutch, a power scooter, a hospital bed, home oxygen equipment, a diabetes self-testing equipment, a seat lift or a nebulizer. If it assists you in your home, you can also use it outside your home. But, even if you need it at home, if it is not medical in nature, such as an air conditioner, Medicare will not cover it.
Medicare also covers disposable supplies that are needed to use the durable medical equipment, including diabetes test strips used with diabetes self-testing equipment, drugs used with nebulizers and lancets.
In order to qualify for Medicare coverage,
- your doctor must certify that you need the equipment.
- the equipment must come from a Medicare-approved medical equipment supplier.
- you must buy certain equipment, but you can rent most equipment.
- you generally must get basic equipment; you usually must pay for any upgrades, unless they are medically necessary.
If the equipment needs to be repaired, Medicare may help cover the cost. If the item is damaged and cannot be repaired, lost or stolen, Medicare will generally replace the equipment. Medicare will also replace equipment that has outlived its useful lifetime and cannot be repaired.
And, if for any reason, Medicare denies coverage, you can appeal. You can send the denial notice back to Medicare, along with a letter from your doctor explaining your need for the equipment, and ask Medicare to review its decision. You have a high likelihood of winning the appeal.
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