Durable Medical Equipment (DME): What Medicare Covers and What It Doesn't

What’s typically covered

• Wheelchairs (manual and power) and walkers
• Hospital beds for home use
• Oxygen equipment and supplies
• Blood sugar monitors and test strips
• Commode chairs and patient lifts
• CPAP machines and supplies

Medicare generally pays 80% after the Part B deductible is met; the remaining 20% is the patient’s responsibility unless supplemented by a Medigap or other secondary policy.

What Medicare requires before it pays

• A face-to-face examination with the ordering physician, documented in the chart — for power wheelchairs and scooters specifically, this is a strict requirement, not a formality.
• A written order that meets Medicare’s specific documentation standard, not just a general prescription note.
• Purchase from a supplier enrolled in Medicare — use Medicare’s supplier directory to confirm before buying, since equipment from a non-enrolled supplier isn’t reimbursed no matter how legitimate it looks.

What Medicare does not cover

Convenience items (a second wheelchair for a vacation home), most home modifications (grab bars, ramps, stairlifts), and equipment intended mainly for comfort rather than medical necessity are typically excluded. Medi-Cal, the VA, or a long-term care insurance policy may cover some of these gaps — worth checking each before paying full price out of pocket.