How Can Seniors Get Help Paying for Durable Medical Equipment?
Durable medical equipment, often abbreviated as DME, includes items like wheelchairs, hospital beds, oxygen equipment, and walkers that help seniors manage health conditions and maintain independence. However, the cost of this equipment can be substantial, leaving many seniors wondering how they will afford the items they need.
What Qualifies as Durable Medical Equipment
For an item to be classified as durable medical equipment, it must meet specific criteria. The equipment must be able to withstand repeated use, meaning it is not disposable. It must serve a medical purpose and be used to treat an illness or injury. The item must be appropriate for use in the home, and it must not be useful to someone who is not sick or injured.
Common examples of DME include mobility aids such as wheelchairs, walkers, canes, and scooters. Patient lifts help transfer individuals who cannot move themselves. Hospital beds provide positioning options for those with medical needs. Oxygen equipment assists those with respiratory conditions. Continuous positive airway pressure machines treat sleep apnea. Blood sugar monitors and supplies help manage diabetes.
Medicare Coverage for DME
Original Medicare Part B covers durable medical equipment when it is medically necessary and prescribed by a doctor. Medicare typically pays 80 percent of the approved amount after you meet your annual Part B deductible. You are responsible for the remaining 20 percent coinsurance. If you have a Medicare Supplement policy, it may cover some or all of your coinsurance.
To receive Medicare coverage, your doctor must provide a written order stating that you need the equipment for use in your home. You must obtain the equipment from a supplier enrolled in Medicare. Using non-enrolled suppliers means Medicare will not pay for the equipment.
Medi-Cal Coverage in California
For seniors who qualify for Medi-Cal, California’s Medicaid program, DME coverage may be more comprehensive. Medi-Cal typically covers medically necessary equipment with little or no cost to the beneficiary. The specific coverage depends on your Medi-Cal plan and the type of equipment needed.
Seniors with both Medicare and Medi-Cal may find that Medi-Cal covers costs that Medicare does not, including the 20 percent coinsurance and deductibles.
Other Assistance Programs
Several other programs can help seniors obtain needed medical equipment. Some charitable organizations provide free or low-cost equipment to those in need. Medical equipment loan closets, often run by nonprofit organizations or churches, lend equipment at no charge. Veterans may be eligible for DME through VA healthcare benefits. Some manufacturers offer patient assistance programs for those who cannot afford their products.
Getting the Equipment You Need
All Seniors Foundation helps seniors access durable medical equipment through various programs and resources. We can help you understand your coverage options, navigate the prescription and authorization process, and connect you with appropriate suppliers. Our home medical equipment services ensure you get the items you need to live safely and comfortably at home.
Do not let cost concerns prevent you from getting equipment that could improve your quality of life. Contact us to explore your options.
