Medicare Pays for Durable Medical Equipment

At Discovery Villages, we support our Senior Citizens by helping them navigate tools and resources that can directly enhance their lives. Talk to our staff at Discovery Villages today to find out about the many ways we can assist our Seniors in getting the best care possible.  

At Discovery Villages, we understand how important it is for our Senior Citizens to get the very best medical care and support to live their best, vibrant lives.  Sometimes this support includes in home medical equipment that can enhance a Senior Citizen’s health and well-being.  If you or someone you know is a Senior Citizen with original Medicare looking to get Durable Medical Equipment that can improve overall quality of life, read below to find out pertinent information and procedures.  

Medicare B, a part of original Medicare, covers a variety of preventative services to keep Senior Citizens active and healthy.  Some services that Medicare B can help pay for include Doctor visits, outpatient care and other medical services such as occupational and physical therapies.  Durable Medical Equipment (DME) can also be partially covered by Medicare B, if the recipient has a qualifying medical need.  Durable Medical Equipment should be used in the Medicare Recipient’s home as an aid, and must qualify as long lasting and durable.

Who qualifies for Durable Medical Equipment?

A doctor will prescribe Durable Medical Equipment to a Medicare Recipient with a qualifying medical need.  The doctor must deem the equipment necessary and used for a specific medical reason or purpose.  Generally, DME is not for someone who is sick or injured. 

What are some examples of Durable Medical Equipment?

• Seat Lift Chairs
• Canes
• Walkers
• Wheel Chairs and other mobility devices
• Blood sugar monitors/ Blood sugar test strips
• Commode Chairs

For a more extensive list of the equipment that Medicare B can cover, go to their website at http://www.medicare.gov/coverage/durable-medical-equipment-coverage.html.

What are the steps to get Durable Medical Equipment Covered by Medicare B?  

There are several steps involved in getting Durable Medical Equipment covered by Medicare.  Most importantly, always choose a doctor and equipment company that are enrolled and participating in Medicare in order to get coverage. 

1. A Medicare enrolled Doctor must write a prescription to the Senior Citizen recipient for the specific Durable Medical Equipment item.  This Doctor must also provide a Certificate of Medical Necessity that states the name of the beneficiary, the start date that it is needed for the equipment, the length of need, and a detailed description of the equipment.  This should be signed and dated by the same doctor.  The medical equipment supplier company will need this Certificate of Medical Necessity for Medicare purposes.
2. Find a medical equipment supplier company that participates in Medicare (otherwise Medicare will not pay the claims).  Once a participating Medicare Supplier is found, they must accept assignment.  However, an enrolled Medicare Supplier who is not “participating” may choose not to accept assignment at that time.  For a list of medical equipment suppliers in a specific area, go to http://www.medicare.gov/supplierdirectory/search.html, read the instructions, type in the zip code where the Medicare Recipient resides and click on the specific durable medical equipment item needed.
3. Check if the equipment company will deliver the service for free or if there are any additional fees.  Find out if the company provides a warranty, and what happens if the equipment gets damaged or broken.  It may be a good idea to find out costs up front, if the equipment needs to be repaired in the future.       
4. Be prepared to pay 20% of the Durable Medical Equipment.  Medicare B covers 80% of the cost of DME, and the Medicare Recipient is responsible for the 20% co-pay.  A medical equipment supplier company will either process orders as “assigned” or “unassigned.”  Generally “unassigned” is more common, and means that everything must be paid up front.  Medicare will later reimburse the Medicare Recipient once the claims are approved.  

At Discovery Villages, our wonderful staff and helpful services give Senior Citizens and their families the peace of mind and support to make the best quality care decisions possible.   Our Connections Transportation services help Senior Citizens get around town, so that they can make that appointment to their physician or shop around for important equipment.  Our Expressions Concierge can also help coordinate deliveries for a hassle free and easy experience.   

Discovery Village At West End offers a variety of senior living programs to keep seniors healthy and active. Learn about our senior living options and amenities today when you contact us at 804.375.4292.