MEDICARE: DURABLE MEDICAL EQUIPMENT (DME)

1. The equipment has been prescribed as medically necessary by your physician. Most items require a Certificate of Medical Necessity (CMN) filled out by a physician; and
2. It must be able to withstand repeated use. Medicare expects a piece of equipment to last 5 years and will not usually pay for like or similar equipment within that time frame; and
3. It must be primarily and customarily used for a medical purpose; and
4. It must generally not be useful to a person in the absence of illness or injury; and
5. It must be appropriate for use at home. Under a provision of federal law, a skilled nursing facility is not considered home; and
6. The durable medical equipment supplier must be a Medicare-certified provider.

See the Center for Medicare Advocacy's website (http://www.medicareadvocacy.org/) for further information on Durable Medical Equipment.

Medicare will cover the following Durable Medical Equipment if items meet the above criteria:
(this is not a complete list)

• home oxygen equipment

• iron lungs
• wheelchairs
• walkers
• hospital beds
• seat lifts

Medicare does NOT cover the following items as Durable Medical Equipment:
(this is not a complete list)

• Insulin and syringes

• Wheelchair ramps

• Hearing aids

• Stair glides

• Wigs

• Surgical stockings

• Tub rails

• Diapers/Depends

For specific questions on items that are covered as Durable Medical Equipment under Medicare Part B call 800-MEDICARE.

TO FIND PROVIDERS IN CONNECTICUT'S COMMUNITY RESOURCES DATABASE THAT PROVIDE MEDICARE INFORMATION AND COUNSELING:

Search by service name: Medicare Information/Counseling.

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SOURCE: Center for Medicare Advocacy website; Centers for Medicare & Medicaid Services, "Medicare Coverage of Durable Medical Equipment," booklet.
PREPARED BY: 211/rj
CONTENT LAST REVIEWED: March2008