Durable Medical Equipment
What Is Durable Medical Equipment and Where Can I Buy It?
Updated Jul 27, 2023
What Is Durable Medical Equipment and Where Can I Buy It?
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When you’re trying to navigate aging in place or managing an illness or disability, it can be hard to keep up with all of the lingo. To help, we’re going to explore a popular term that you’re likely to encounter as you age: durable medical equipment (DME).
DME might sound straightforward since you already know what each word means, but it’s actually a specific term used by Medicare, Medicaid, and other insurance companies. In general, durable medical equipment is medically necessary supplies and devices that you can use over and over again.
Seniors, who are more likely to have a chronic illness or mobility difficulties, need durable medical equipment more than other age groups.1 That’s why we’re going to cover DME items, insurance coverage for durable medical equipment, and more below.
Durable medical equipment includes medical devices and supplies that can be used again and again, such as a hospital bed in your home or a prosthetic limb. The opposite of DME would be single-use medical equipment like bandages or incontinence pads.
It’s important to understand what counts as DME and what doesn’t, because that affects insurance coverage. Most government and private health insurance plans will cover all or some of the expenses associated with durable medical equipment.
To qualify as DME, the item must:2
The most common examples of durable medical equipment used outside of a hospital include:
When you read over the criteria for durable medical equipment, it sure seems like hearing aids should count. After all, you wear them every day, and they last longer than three years. Unfortunately, they aren’t considered DME.
Nearly 25 percent of those aged 65 to 75 and 50 percent of those 75 and over experience hearing loss, but hearing aids still aren’t classified as durable medical equipment or covered by Medicare and most private insurance companies.3
Instead, hearing aids are classified as elective or Class I medical devices.4 Class I medical devices, by definition, aren’t medically necessary. Since DME only includes medically necessary items, hearing aids don’t qualify. If you’re worried about the cost of hearing aids since they’re not classified as Medicare-approved DME, watch the video below. Audiologist Brad Ingrao covers the best ways to find free or reduced-cost hearing aids.
As you saw above, durable medical equipment includes reusable devices and supplies that serve a medical purpose. Adaptive equipment is another category of equipment that helps seniors and those with short- or long-term disabilities, but it doesn’t have to serve a medical purpose.
The category of adaptive equipment includes devices and supplies that assist with mobility, activities of daily living (ADLs), and instrumental activities of daily living (IADLs).5 That means items that help make dressing, bathing, toileting, eating, communication, entertainment, and mobility easier, safer, or more accessible. The chart below outlines examples of adaptive equipment so you can differentiate them from DME.
| For ADLS | For IADLS | For Mobility |
|---|---|---|
|
|
|
For the most part, adaptive equipment is not considered medically necessary, so it is not durable medical equipment nor covered by insurance. However, there are a few exceptions. For example, Medicare labels commodes, canes, scooters, and wheelchairs as durable medical equipment in certain situations.
On Medicare? You may be in luck if you need durable medical equipment. Medicare Part B covers DME as long as your medical provider prescribes it for home use.
Under Original Medicare, Medicare covers 80 percent of the cost, so you need to pay 20 percent of the Medicare-approved amount. The Part B deductible also applies. Just make sure that the doctor prescribing the equipment and the supplier are both enrolled in Medicare. If not, Medicare won’t pay the claims.
Medicare also covers DME in different ways. Depending on what equipment you need, Medicare might say that you need to rent the equipment, that you need to buy the equipment, or that you can choose whether to rent or to buy the equipment.
The easiest way to find local Medicare-approved DME suppliers is to use Medicare’s official Find Medical Equipment and Suppliers search tool. You can use the tool in two different ways.
You can also contact Medicare directly with any questions about equipment coverage or finding a supplier:
Once you find a supplier, remember to ask about costs and coverage to ensure that you pay as little as possible out of pocket.
Medicaid programs vary from state to state, which means that what Medicaid covers also varies by state. To find the most relevant information, we recommend calling your state’s Medicaid office or visiting their website.
In general, Medicaid will cover medical equipment that’s medically necessary and cost-effective, and that meets the state’s definition of durable medical equipment. That definition varies, but it’s often similar to the one that Medicare uses. Many state Medicaid programs cover 100 percent of the cost of any home medical equipment you need.
Receiving Medicaid coverage for durable medical equipment typically looks like this:
Again, the process will vary depending on where you live. We just wanted to give you an idea of what to expect.
Sometimes Medicare or Medicaid won’t pay for the item you need, or maybe you just don’t want to wait to find out if what you need will be approved. In either case, here are a few other ways that you can pay for durable medical equipment:
Business Wire. (2019). North America Durable Medical Equipment Market to 2027 with Performance of Key Players – Medtronic, BD, Medline Industries – ResearchAndMarkets.com.
Medicare.gov. (2021). Durable medical equipment (DME) coverage.
NIDCD. (2021). Quick Statistics About Hearing.
Audiology Consults. (2021). Does Medicare cover hearing aids?.
BraunAbility. (2021). What Is Adaptive Equipment? How Adaptive Equipment Helps in Your Daily Life.
Medicare.gov. (2021). Durable medical equipment (DME) coverage.
Medicare Interactive. (2021). Equipment and supplies excluded from Medicare coverage.