Medical Equipment Coverage: What Medicare Pays For and How to Get It

If you’re wondering whether Medicare will foot the bill for a hospital bed, a wheelchair, or a special cushion, you’re in the right place. This guide breaks down the basics, shows you what counts as covered equipment, and gives you a step‑by‑step plan to claim it without getting lost in red tape.

Which Items Are Considered Durable Medical Equipment?

Medicare uses the term “durable medical equipment” (or DME) for items that can be used at home, are medically necessary, and last at least three years. Common examples include hospital‑grade beds, adjustable chairs, walkers, and oxygen tanks. The key is that a doctor must write a prescription stating the item is needed for a health condition.

Not everything that helps at home qualifies. Simple pillows, regular office chairs, or decorative rugs don’t meet the medical necessity test, so Medicare won’t cover them. When you’re shopping, look for the word “DME” on the product description or ask the supplier whether the item is Medicare‑approved.

How to Apply for Coverage and Avoid Common Pitfalls

First, get a written order from your doctor. The order should name the exact equipment, its purpose, and any specific features you need. Next, find a Medicare‑enrolled supplier. Using a non‑enrolled vendor can mean you pay out of pocket and may not get reimbursed later.

When you receive the equipment, the supplier will file a claim with Medicare on your behalf. Keep all receipts, the doctor’s order, and any delivery paperwork. If the claim is denied, you can appeal within 60 days. Common reasons for denial are missing documentation or the equipment not meeting the “medically necessary” rule.

For items like chair cushions, Medicare only covers them if they’re part of a larger DME item (like an adjustable bed) or if a physician states they’re needed to prevent skin breakdown. Double‑check the specific coverage rules on the Medicare website or call their helpline before you buy.

Finally, remember that Medicare Part B covers most DME, but you’ll usually pay a 20% coinsurance after meeting your deductible. If you have a supplemental plan, it may cover part or all of that cost. Knowing your out‑of‑pocket responsibility upfront can prevent surprise bills.

In short, the process isn’t magic, but it’s manageable. Get a doctor’s order, choose an approved supplier, keep your paperwork, and stay on top of the claim status. With those steps, you can get the equipment you need without breaking the bank.