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Durable Medical Equipment

Durable Medical Equipment (DME) is any equipment for beneficiary use that helps them live a better quality of life. DME, covered by most health insurances. An authorized provider is any individual, institution/organization, or supplier that is licensed by a state, accredited by national organization, or meets other standards of the medical community, and is certified to provide benefits. There are two types of insurance-authorized providers: Network and Non-Network..

To be considered DME, the equipment must be medically necessaryTo be medically necessary means it is appropriate, reasonable, and adequate for your condition. and reusable. Most insurance covers the cost of medical supplies when related directly to a covered medical condition and when those supplies are obtained from a medical supply company, a pharmacy, or an authorized provider.

DME can be rented or purchased, but your regional contractor will determine which is most appropriate for your situation. The contractor will consider your prescription, your current medical condition, and the amount of time you will need the DME. Insurance companies will pay for the replacement of a medically required DME that you own if your medical condition changes or equipment malfunction because of reasonable wear and usage. If you accidentally damage a DME that you have purchased and the manufacturer’s warranty has expired, most insurance companies will also cover the cost of repairs or replacement costs.

Two popular examples of prescribed DME are walkers and continuous positive airway pressure (CPAP) machines. Recently, Recently insurance companies added breast pumps and breast pump supplies to its list of DME. 

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