Most people discover durable medical equipment coverage the hard way - after they already need a wheelchair, hospital bed, or CPAP machine and are not sure what Medicare will pay for. This article covers the basics so you know what to expect before you get to that point.
What Durable Medical Equipment Is
Durable medical equipment, or DME, is a category of medically necessary equipment prescribed for use at home. "Durable" means it can withstand repeated use. "Medical" means it serves a health purpose, not just convenience. Medicare's definition is specific: the item must be able to withstand repeated use, primarily serve a medical purpose, not be useful to someone who is not sick or injured, and be appropriate for use at home.
Common examples covered under Medicare include:
- Wheelchairs (manual and power)
- Mobility scooters
- Walkers, canes, and crutches
- Hospital beds
- CPAP and BiPAP machines
- Home oxygen equipment
- Blood glucose monitors and supplies
- Nebulizers
What Medicare does not cover: comfort items (even if recommended by a doctor), equipment not prescribed for a medical condition, and equipment purchased from suppliers who are not enrolled in Medicare.
How Does Medicare Part B Cover Durable Medical Equipment?
Medicare Part B covers DME that your doctor prescribes as medically necessary for home use. You generally pay 20% of the Medicare-approved amount after your Part B deductible is met. Medicare pays the other 80%. You must use a Medicare-enrolled supplier, and the equipment must meet Medicare's definition of 'durable' — designed for repeated use and primarily medical in purpose.
DME is generally covered under Medicare Part B, though it may be covered under Medicare Part A if you are a hospital inpatient or staying in a skilled nursing facility. The basic cost-sharing structure for 2026:
- You pay the Part B deductible ($283 in 2026)
- After the deductible, Medicare pays 80% of the Medicare-approved amount
- You pay the remaining 20%
This 20% coinsurance is real money for expensive equipment. A Medigap (Medicare supplement) plan can cover some or all of that 20%, depending on the plan type. If you have a Medicare Advantage plan (Part C), the plan must cover at least what Original Medicare covers, but the cost-sharing structure may be different - check your plan documents.
Important: The supplier generally needs to be enrolled in Medicare and may need to accept assignment for coverage to apply. If they accept assignment, they can only charge you the deductible and coinsurance - nothing more. Ask before you order.
What Does 'Medically Necessary' Mean for DME Coverage?
Medicare requires a written order from your doctor stating that the equipment is medically necessary for your condition and for use in your home. The documentation must link the equipment to a specific diagnosis. Items considered comfort or convenience items — even if genuinely helpful — may be denied. The supplier can tell you what documentation is required before you order.
For Medicare to cover DME, your doctor must document that the equipment is medically necessary for your condition. This means:
- A written order from a physician or other qualified provider
- Documentation in your medical record supporting the need
- In some cases, a face-to-face examination
"My doctor thinks it would be helpful" is not sufficient on its own - there needs to be a documented clinical reason tied to a diagnosis. This is where coverage is sometimes denied: the paperwork does not adequately establish medical necessity even when the clinical need is genuine.
Does Medicare Have You Rent or Buy DME?
Medicare's decision to rent or buy depends on the type of equipment. For most items, Medicare rents the equipment for 13 months and then you own it. For certain complex or expensive items, Medicare may purchase immediately. The supplier handles the billing either way. After ownership transfers, Medicare covers maintenance and repairs for as long as the equipment is medically necessary.
Medicare's rules on whether you rent or buy DME depend on the type of equipment:
- Inexpensive or routinely purchased items - Medicare Part B helps cover the purchase (canes, walkers, blood glucose monitors) — after meeting your Part B deductible, Medicare typically pays 80% of the approved amount, and you pay the remaining 20%.
- Rental items - Medicare rents the equipment for a set period, then may convert to purchase (wheelchairs, scooters, hospital beds, CPAP)
- Capped rental items - After a certain rental period (often 13 months for items like power wheelchairs), Medicare stops paying rental and you own the equipment
The practical implication: for powered wheelchairs and scooters, Medicare essentially rents the equipment through a supplier for the capped rental period, then ownership transfers to you. During the rental period, the supplier is responsible for servicing and repairs.
How Do You Find a Medicare-Approved DME Supplier?
Use Medicare's supplier directory at medicare.gov or call 1-800-MEDICARE. Using a Medicare-enrolled supplier is required for coverage. For certain types of equipment in competitive bidding areas, you must use a supplier who participates in Medicare's competitive bidding program — your doctor's office or Medicare can tell you if this applies in your location.
Not all medical supply stores participate in Medicare. Using a non-participating supplier means Medicare still generally pays 80% of the Medicare-approved amount, but the supplier may charge more than that approved amount — and you could be responsible for the difference.
Use the Medicare supplier directory at medicare.gov/suppliers to find approved suppliers in your area. You can filter by equipment type and zip code. Always confirm Medicare participation before ordering anything.
Medicaid and DME
If you have Medicaid (or both Medicare and Medicaid), Medicaid may cover some DME costs that Medicare does not, including the 20% coinsurance. Medicaid DME coverage varies significantly by state - contact your state Medicaid office for specifics.
Key Resources
- Medicare DME coverage overview - medicare.gov/coverage/durable-medical-equipment-dme-coverage
- Medicare supplier directory - medicare.gov/suppliers
- 1-800-MEDICARE (1-800-633-4227) - For questions about coverage and approved suppliers
DME coverage rules and the Part B deductible amount are updated annually. Confirm current figures at medicare.gov or by calling 1-800-MEDICARE.