Medicare DME: What Patients Should Know

What Medicare Part B Covers

Medicare Part B covers durable medical equipment that's medically necessary, prescribed by a Medicare-enrolled doctor, and used in your home — including wheelchairs, walkers, hospital beds, CPAP machines, and oxygen equipment. Coverage applies whether Medicare pays for the equipment as a rental or a purchase, depending on the category.

How Much You'll Pay

Original Medicare typically pays 80% of the Medicare-approved amount for DME once you've met your annual Part B deductible, leaving you responsible for the remaining 20% as coinsurance. Supplemental (Medigap) coverage can reduce or eliminate that 20% share, depending on the plan.

Rent or Buy?

Medicare decides whether specific equipment is rented or purchased based on its category — some items, like hospital beds, are typically rented on a monthly basis, while others are purchased outright. Your supplier will know which applies to a given item and can walk you through what that means for your ongoing costs.

When Prior Authorization Applies

Medicare requires prior authorization for a specific list of DME items, most notably certain power wheelchairs and scooters and some pressure-reducing support surfaces. Your supplier submits the request to Medicare's DME contractor, which generally responds within 10 business days — faster if a delay would put your health at risk.

Medicare Advantage vs. Original Medicare

Medicare Advantage (Part C) plans must cover at least what Original Medicare covers, but they administer DME benefits through their own network rules — which can mean different in-network suppliers, referral requirements, or authorization thresholds. Confirming your specific plan's rules before ordering avoids a surprise out-of-network bill.

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