What do a pair of crutches, an oxygen tank, and a bunch of blood sugar (glucose) test strips have in common? If you said they're all medical tools you might use at home, you're right. And if you're enrolled in Medicare, it's important to know whether those tools are covered by your health plan.
Medicare Advantage vs. Original Medicare
Medicare Advantage plans cover all the same home health equipment as Original Medicare. Home health equipment that's covered by your Medicare plan is called durable medical equipment (DME). Not all medical equipment qualifies as DME, so make sure to check with your plan to see if the equipment you need will be covered.
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A crash course in DME
So what exactly is DME? It's a device or type of medical gear prescribed for use at home. All DME have to meet the following criteria:
- Durable (can withstand repeated use)
- Used for a medical reason
- Not usually useful to someone who isn't sick or injured
- Used at home
- Has an expected lifetime of at least three years
If your durable medical equipment doesn't meet all of the above, it might not be covered. For example, do you use a portable humidifier? If your doctor prescribed one to help you with your asthma, it may be covered. If you bought it on your own because the air in your room was dry, it's probably not.
Other examples of DME include crutches that are used by someone who can't walk because of a broken bone or another health-related issue, an oxygen tank prescribed by a doctor for a medical condition, and blood sugar test strips needed by people living with diabetes. All of these items are "medically necessary" for their users, so they qualify as DME.
Identifying DME isn't the easiest thing in the world – even after this crash course. If you're still unsure if your personal medical equipment qualifies as DME, it's best to let the experts figure it out. Ask your doctors or health care providers. They'll be able to give you more detailed information on available equipment options, potential costs, and any other DME-related questions. You can also call your Medicare plan for specific details on the type of equipment it covers.
Chris Markle is a health care writer at Aetna with a background in Medicare, Medicaid, and regulated health insurance products. After graduating from Northeastern University with a degree in journalism, he cut his teeth in the biotech industry and explored his passion for patient advocacy and engagement. An unabashed Jets fan living in Patriots-land, Chris is always willing to have a conversation about the latest MBTA scandal or jam out with his band, Trippin' the Stone.
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