When it comes to medical terms, it can be confusing to keep up with all the health care terms. As you age, there is one term that you will likely hear more than once – Durable Medical Equipment or DME. DME is a specific medical term used by insurance companies like Medicare and Medicaid.
What is Durable Medical Equipment?
Durable Medical equipment is any medical device or supplies that are necessary for a person’s health, which can be used for a long-term basis.
Purpose examples:
- Used mainly for a medical purpose.
- Ordered by a health provider.
- Used for a long-term basis of at least a few years.
- Used in a home.
- Only used by patients that have an illness, injury, or disability
Durable Medical Equipment Examples:
- Oxygen concentrators, monitors, and ventilator supplies
- Bed equipment
- (i.e. Bili lights or blankets, hospital beds, lift beds, or pressure mattress)
- Kidney Machines
- Orthotics
- Personal care assistive equipment
- (i.e. shower chairs, commodes, and dressing aides)
- Mobility assistive equipment
- (i.e. canes, crutches, scooters, walkers, and wheel chairs)
- Prostheses
DURABLE MEDICAL EQUIPMENT (DME) IS COVERED BY MEDICARE PART B
Medicare Part B covers durable medical equipment IF YOUR MEDICAL PROVIDER orders it for home use. When requesting DME, it is vital to make sure that your medical doctor and supplier are both enrolled in Medicare.
IS DME COVERED BY MEDICAID?
Like any government insurance, Medicaid programs and coverage vary by state. If you need DME, it is recommended that you contact your local Medicaid office to determine what is covered. Medicaid typically covers medical equipment that is both affordable and medically necessary for a patient. Some state Medicaid programs cover all the cost for durable medical equipment, while others only pay for a portion of it.
If you are enrolled in Medicaid, you may be wondering what the process looks like for requesting DME. While the qualification process varies by state, here is a basic idea of what to expect. You will first receive a letter from your doctor that lists what you need. Then, you will choose a supplier enrolled in Medicaid and take your letter to them. Your supplier will fill out a prior approval (PA) application and send it to your state Medicaid office, who will either approve or deny the request. Any approved request will allow the supplier to send you the DME and bill your insurance. For denied requests, you will be mailed a letter explaining the reason and information for how to appeal the decision.
We do hope you will be better informed about what this term means and what you need to know in case you or a loved one require DME to live safely at home.
As a leader in Scientific Equipment Repair and Medical Equipment Calibrations, Scientific Instrument Center works with many corporations, universities, and hospitals providing the highest level of laboratory services.
If you have questions about your laboratory equipment and would like to discuss options for repairing or maintaining the equipment, please contact us toll free at (800) 686-8965
Our skilled staff members understand the nuances of instrument calibration and the manufacturers train our technicians, so any inspections we make mean your equipment is to quality standards. For more than 30 years, SIC has served businesses that use a wide variety of diagnostic and scientific equipment. We are specialists!
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