What does Durable Medical Equipment (DME) coverage in Medicare include?

• A. Coverage for durable equipment prescribed by a clinician is only through rental.
• B. Coverage for medically necessary durable equipment prescribed by a clinician, with a rental or purchase option and monthly cap.
• C. DME is never covered by Medicare.
• D. DME requires prior authorization for all items.

Answer: (B)

Medicare covers Durable Medical Equipment when a clinician documents medical necessity and provides a prescription. The equipment must be durable, used for a medical purpose in the home, and appropriate for the patient’s condition. If approved, you have the option to rent the item or purchase it, depending on the item and the supplier, with Medicare helping cover the cost. There is typically cost-sharing for the patient (deductible and coinsurance), and some items may require prior authorization, but not all do.