Healthcare has been transformed by the rapidly changing furniture, devices, and gadgets we know as Durable Medical Equipment (DME). Today it is possible to set up an entire hospital room at home thus reducing the anxiety of illness and recovery in unfamiliar surroundings.
DME categories include:
- Mobility – walkers, canes, crutches, knee walkers, rollators, and mobility accessories
- Bath Safety – bath benches, bath accessories, transfer benches, elevated toilet seats, grab bars, safe-t-poles, and commodes
- Wheelchairs – narrow, basic, extra-wide, antimicrobial, bariatric, pediatric, recliner, hybrid, translator, transport, and cushions and accessories
- Hospital Beds – MedLite, basic, simplicity, bariatric, bed accessories, mattresses, side rails, trapeze bars, and overbed tables
- Patient Handling – bath lift, stand assists, floor lifts, slings, lifts and vests, gait pacers, patient safety devices, transfer board, transfer sheets, and stretchers
- Patient Safety Alarms – pressure-sensing safety, pull cords, wireless, talking, and specialty alarms
- Therapy – Resistive exercise, Tens units, pain relief, exercise balls and mats, exercisers, instant packs, ice bags, activities of daily living products and tools
Medicare Part B
Covers the care you receive outside the hospital or nursing home care. This pays for outpatient and therapy care, doctor’s visits, prevention care like vaccinations and DME. Here is a list of the most common DME covered when prescribed by a physician as ‘medically necessary’ and within the limits of Medicare’s approved vendors:
- Blood sugar monitors
- Blood sugar test strips
- Commode chairs
- Continuous passive motion devices
- Continuous Positive Airway Pressure (CPAP) devices
- Hospital beds
- Infusion pumps & supplies
- Lancet devices & lancets
- Nebulizers & nebulizer medications
- Oxygen equipment & accessories
- Patient lifts
- Pressure-reducing support surfaces
- Suction pumps
- Traction equipment
- Wheelchairs & scooters
Medicare Part C
Is commonly known as Medicare Advantage. These plans are purchased through insurance companies. They cover the items listed here for Parts A & B and Part D. Each Medicare Advantage plan sets up their benefits profile and cost paid by members depending on the local market where they are selling the plans. Some of these plans now offer vision, hearing, and dental coverage (which regular Medicare does not). Medicare Advantage covers DME like Medicare Part B and sometimes beyond. Medicare Advantage plans offer benefits to address social needs as well as medical.
How to select the right DME
Have you ever bought a car or a truck? How did you feel when you were negotiating? Unless your last name is Ford, you probably didn’t discuss how a car is made at the dinner table. The same goes for durable medical equipment purchasing. Your ability to choose the right equipment is dependent on your knowledge and familiarity with these products.
New equipment is most likely needed after a significant event such as a broken bone, car accident, medical crisis, or illness. Therefore, your DME decisions will be guided by the care team working with you at the time. Rehabilitation therapists (physical, occupational, speech, respiratory, and recreational to name a few) will likely introduce the equipment you will use at home during your hospital stay. Additionally, the discharge planners, social workers, and nurse educators also provide training and education to make sure the patient and family members can carry on with the right practices to continue recovery at home. Lastly, the home-based services and your primary care providers take over managing your recovery and DME use until it is no longer required.
There are so many factors to consider when choosing DME. We strongly advocate that a home visit by a therapist be conducted BEFORE hospital discharge and/or ordering the DME.
- Who will use the equipment (how many people needed to operate it?)
- What skills will be needed to operate the equipment?
- Will it fit in your home? What are the options?
- How long will this equipment be useful? What happens if physical or mental decline renders it useless?
- Is the selection customized to the person? Is it sized right? What special features will make it right for you?
- Who will assemble the equipment?
Understanding insurance reimbursement for medical devices can be tricky. We recommend that you consult your insurance handbook for more information on coverage.