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Durable Medical Equipment: What’s Covered & What’s Not?

Family caregivers often ask, “What equipment does my loved one need to live safely is his or her home, and is covered by insurance?” Whether your loved one has recently been discharged from a hospital, nursing home or rehabilitation facility, or you are simply doing research on your own, we recommend seeking the advice of various qualified professionals, including physical and occupational therapists, nurses, social workers and physicians.

Home care providers, like Home Helpers®, interact with these professionals, as well as equipment suppliers, on a frequent basis. Medical equipment (often called "durable medical equipment" or DME) is either rented or purchased for use in the patient's home, and is often covered (sometimes partially) by Medicare and most Medicare Managed Care plans.

We highly recommend choosing a qualified and responsive DME provider that:

  • Stocks a wide range of products you may need.
  • Has knowledgeable sales and customer service reps.
  • Has relationships with the area’s medical community.
  • Has a fast response time, operates 24/7, and employs a qualified, trained and courteous delivery staff.

Medicare regulations change periodically, so check with your local Medicare office for information on any specific equipment you may need. Medicare generally defines durable medical equipment as equipment that is reasonable and necessary for the individual, and:

  • Can withstand repeated use.
  • Is primarily used to serve a medical purpose.
  • Is not useful to a person in the absence of illness or injury.
  • Is appropriate for use in the home.

What is Covered?

Medicare Part B covers a wide range of medical equipment for use in a client’s home. Some equipment must be rented, some purchased, and often the client has a choice. Equipment must be medically necessary and prescribed by a doctor.

Covered equipment can include hospital or other special beds; patient lifts; commode chairs; canes, crutches, walkers, and wheelchairs (manual and power); oxygen equipment; traction equipment; infusion and suction pumps; nebulizers; blood sugar monitors; dialysis machines; and other equipment.

Medicare Part B does not cover equipment that is permanently installed in a client’s home, such as a ramp or special shower stall. Also, most bathroom equipment such as tub seats, transfer benches, toilet rails, grab bars and handheld showerheads and hoses, are not covered.

Are Scooters Covered?

Medicare Part B pays 80% of the Medicare-approved amount for the rental or purchase of a scooter. For coverage of a scooter, the equipment must be prescribed by a physician because the individual needs it to be mobile within his or her place of residence not just when leaving home. Before a physician writes a prescription for a scooter, the physician must determine what equipment is needed and whether the person can safely and effectively operate it.

During the rental period, the supplier is responsible for maintenance and repair of the equipment. If repair is necessary, the supplier must fix the equipment at the client’s home, or pick it up and return it. Rental payments for a scooter are capped at 13 months total. After 13 months of rental payments, the individual owns the equipment.

Are Lift Chairs Covered?

A seat lift mechanism raises an individual from a sitting position to a standing position by gently raising and slightly tilting the chair. It may be covered by Medicare if a person is not able to stand up from any chair in the home. The person must be able to walk once they reach a standing position. The fact that an individual has trouble or is unable to get up from a chair, even a low chair, does not justify the need for a seat lift. The patient must have severe hip or knee arthritis or have a severe neuromuscular disease.

The seat lift mechanism must be part of the doctor’s course of treatment and be prescribed to improve, or prevent deterioration of, the client’s condition. Medicare only covers seat lift mechanisms that operate smoothly, can be controlled by the individual, and assist the individual in standing up without other help. Medicare covers only a seat lift mechanism, not the cost of an entire chair.

To learn how Home Helpers can help you with your loved one’s needs, including personalized in-home care and help with your durable medical equipment questions, call (877) 464-9090 or contact us online.

Karen Devine, Community Relations Director for Medical Home Care, contributed to this article. Medical Home Care provides Respiratory and Home Medical Equipment and offers free same-day delivery seven days a week. The company is family-owned and operated and has served the 5-county area since 1976. Call 610-687-6585 or visit their web site at www.medicalhomecareinc.com.

About Home Helpers®
Home Helpers is the premier provider of in-home, non-medical and personal care and companionship for seniors, people coping with a lifelong illness or disability, and those recuperating from a recent surgery or hospitalization. Home Helpers is an agency, not a registry. We employ caregivers who are thoroughly screened using our exclusive Care Check System™. By utilizing our Client & Caregiver Matching System™, we ensure the best caregiver selection. We are committed to the delivery of a positive home care experience for your family.

We don’t just take care of our clients, we plan for them, using our comprehensive and customized Home Helpers Total Care Plan™. Home Helpers is proactive, not reactive, and offers a flexible, affordable continuum of care that changes as our clients’ needs change. We tailor our care plans to our clients’ unique needs and tap our extensive network of referral resources relevant to every aspect of care.

From occasional visits to respite to hospice care, the team at Home Helpers is with you every step of the way, providing guidance, reassurance and compassionate care always.

To learn how we can put together a Total Care Plan™, including helping with a continuum of care plan for you or your loved one, call us at (877) 464-9090 or learn more online.


“Phyllis has been taking care of my father for the past couple months and I wanted to pass along how well she's been doing. Each time I talk with my Dad, he tells me how much he appreciates having the same person come now and how well she's taking care of his place. By having a reliable person come and take care of my Dad, it takes the stress off our family and we all really appreciate it.”

Kathy S.
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