1901 Central Drive, Suite 800 Bedford, TX 76021

Eligibility for DME coverage

Eligibility for DME coverage

Whether you have Original Medicare or a Medicare Advantage Plan, Medicare covers your durable medical equipment (DME) if you meet the following two conditions:

  1. Your primary care provider (PCP) must sign an order, prescription, or certificate after a face-to-face office visit.
    1. In this document, your PCP must state that the required office visit occurred, that you need the requested DME to help a medical condition or injury, and that the equipment is for home use.
    2. Your face-to-face office visit must take place no more than six months before the prescription is written.
  2. Once you have your PCP’s order or prescription, you must take it to the right supplier to get coverage. Be sure only to use suppliers with approval from Original Medicare or your Medicare Advantage Plan.

Note: There is a different process if you need coverage for a manual or power wheelchair or scooter.