Healthcare.gov defines DME as:
"Equipment and supplies ordered by a health care provider for everyday or extended use."
Durable Medical Equipment includes and extremely wide variety of supplies including orthopedic bracing, hospital beds and accessories, mobility and safety aids, urinary and incontinence supplies, oxygen equipment, wheelchairs, crutches and blood testing strips for diabetics. Of course, the list does not stop there.
Simply put, to be classified as Durable Medical Equipment (DME), the equipment must serve a medical purpose and last for at least the duration of medical need.
DME for Me is a Medicare Part B enrolled Provider and accepts Medicare assignment, you (or your secondary insurance) pay 20% of the Medicare-approved amount, and the Part B deductible applies. Medicare pays for different kinds of DME in different ways. Depending on the type of equipment:
Medicare will only cover your DME if your doctors and DME suppliers are enrolled in Medicare. Doctors and suppliers have to meet strict standards to enroll and stay enrolled in Medicare. If your doctors or suppliers aren’t enrolled, Medicare won’t pay the claims submitted by them.
Make sure your doctors and DME suppliers are enrolled in Medicare. It’s important to ask your suppliers if they participate in Medicare before you get DME. If suppliers are participating suppliers, they must accept assignment (which means, they can charge you only the coinsurance and Part B deductible for the Medicare‑approved amount). If suppliers aren’t participating and don’t accept assignment, there’s no limit on the amount they can charge you. Medicare won’t pay claims for doctors or suppliers who aren’t enrolled in Medicare.
Durable Medical Equipment Suppliers to not set the price that we charge your insurance provider for your DME, in fact, the price is set by the Center for Medicare/Medicaid Services.
A complete price list that Medicare sets for all Durable Medical Equipment is freely available on CMS.gov.
Other insurance carriers, private and state, follow closely with Medicare and rarely deter a significant amount from what Medicare has set.