Does Medicare Pay for Durable Medical Equipment Repairs?
Last Updated : 09/12/20184 min read
If you use durable medical equipment (DME) such as walkers, hospital beds and oxygen units, you might be wondering who’s responsible for repairs and maintenance. The answer depends on the situation. But first, let’s start with a little background about what durable medical equipment is.
What is durable medical equipment?
As far as Medicare is concerned, durable medical equipment (DME) refers to certain items your doctor orders for you to use in the home.
These items must be used for medical reasons, able to withstand repeated use (for at least three years), used primarily at home, and not useful to someone who’s healthy and not injured. Although this equipment is durable, it might need repair or maintenance from time to time.
Does Medicare pay for durable medical equipment?
Generally, Medicare coverage of durable medical equipment falls under Medicare Part B. Part A may pay for certain DME if you’re under hospice care.
Medicare will typically pay 80% of the Medicare-allowed amount for most covered durable medical equipment. Your doctor needs to prescribe it for you to use in your home. You are responsible for the other 20%, unless you have other coverage such as a Medicare Supplement plan. Your Medicare deductible applies.
If you’re enrolled in a Medicare Advantage plan, your plan is required to provide at least the same level of coverage as Medicare Part A and Part B. If you need hospice care, that will still be covered under Part A and not through your Medicare Advantage plan.
Some Medicare Advantage plans provide additional coverage besides Part A and Part B benefits. To learn more details about your durable medical equipment coverage, contact your plan’s customer service department.
What types of durable medical equipment does Medicare cover?
Medicare may cover different kinds of durable medical equipment and supplies. Here are some examples of what Medicare might cover: wheelchairs, blood sugar monitors, commode chairs, hospital beds, infusion pumps and supplies, nebulizers and nebulizer medications, sleep apnea and Continuous Positive Airway Pressure (CPAP) devices, suction pumps, oxygen equipment and supplies, lifting devices, traction equipment, canes, crutches, and walkers.
Who’s responsible for durable medical equipment maintenance and repairs?
Your durable medical equipment supplier usually takes care of any maintenance and repairs, if you’re renting your equipment. In fact, you may want to ask the supplier whether they even let you do your own repairs or maintenance.
If you own your equipment, you might need to do the maintenance yourself, or have someone do it for you. An owner’s manual might give you some information you need. For example, if you have a motorized wheelchair, you might want to know how to:
- Recharge the wheelchair battery
- Avoid overcharging the battery
- Store your wheelchair and battery to preserve battery life
- Travel safely by air with your wheelchair and battery
If you’re a do-it-yourselfer, or have a friend who is, there are some videos you can view online that may be helpful.
You may want to have the supplier maintain and repair your equipment, especially if it’s complex. For example, if you have a wheelchair, your supplier’s professional technicians can inspect and repair (as necessary) wheels, castors, arm and leg rests, the wheelchair frame, electronics and positioning device.
Who pays for durable medical equipment maintenance and repairs?
Durable medical equipment repair and maintenance might be paid mostly by Medicare or the supplier, depending on the situation. In some cases, you may need to pay a portion of the repair or maintenance costs.
- If you’re renting your durable medical equipment, the supplier should cover repair and maintenance costs. The supplier usually picks up the equipment so you don’t have to transport it.
- If Medicare has already covered your durable medical equipment, Medicare might cover the costs to repair or replace the DME if it’s lost or damaged. Medicare may even cover rental costs of durable medical equipment while yours is being repaired. You might need to pay 20% of the rental or repair costs.
- If you own your DME, Medicare generally pays 80% of the costs to repair your durable medical equipment.
Please note: If you use a DME supplier who does not accept Medicare assignment, you may have to pay more for durable medical equipment, including maintenance, repairs, or replacement. Read more about durable medical equipment suppliers.
If you have questions about Medicare durable medical equipment benefits or your Medicare coverage options, I can help you.
- Use the links below to schedule a phone call or have me email information to you.
- Begin by searching for plans in your service area by clicking the Compare Plans or Find Plans buttons on this page.