Durable Medical Equipment, or DME, is therapeutic medical equipment that is covered under Medicare Part B and sometimes Part A. DME can be covered if the equipment is durable, generally meaning if it can be used repeatedly, if it can be used at home, and if it actually helps the patient in question.
Generally, Medicare will not cover home modifications like handrail additions or ramps. It will cover:
While some DME products can (and should) be purchased, others (like oxygen equipment) can only be rented. The first step is to get your client to a doctor because they’ll need a prescription to prove that they need the DME. Without seeing a doctor (within six months before the purchase/rent date), Medicare may not cover your client’s DME. Some items, like wheelchairs, may be harder to get coverage for. Your client will have to prove that he genuinely has trouble getting around even with a cane or walker.
You can help your clients find DME suppliers by going to https://www.medicare.gov/supplierdirectory/search.html. However, Medicare Advantage plans may have their own DME suppliers, so check with your client’s specific plan and know the facts.
Hospitalized clients will receive DME coverage through Medicare Part A, but others will fall under Part B. In that case, Medicare will pay 80% of the cost (after they’ve met their deductible).
If you need help explaining concepts like DME to your clients, Senior Market Advisors may be a great option for you. Our training tools like our webinars, videos, and SMA University will make it easy for you to learn these concepts and then focus on what you do best: selling. Learn more about SMA by watching our video.