Durable Medical Equipment

Understanding Durable Medical Equipment
Written by Nancy McMahon   
The term durable medical equipment is one most used by Medicare and Social Security to describe medical devices that are needed by a patient for specialized medical care in a patient’s home or long-term care institution.

This equipment can include transportation assistance, canes, crutches, bed-lifts, breathing apparatuses and some diabetic supplies. Durable Medical Equipment or DME, is a specified paid Medicare benefit for people who need at-home assistance following an accident or illness. This care may be considered temporary or permanent.

Often durable medical equipment is rented with the intent of using it for a specific amount of time. This is often after an accident, where a wheelchair might be needed for a time, then a walker and finally crutches before the patient is able to walk without assistance. 

The patient’s doctor will determine the type of DME that is required. Estimation will be given as to how long the devise is needed for. The physician will write a prescription for the equipment. This prescription is similar to a drug prescription. An authorized DME supplier will fill the prescription for the equipment.

Equipment Qualification

Identifying what qualifies as Durable Medical Equipment (DME) is fairly easy. This technical term is used as a guideline by Medicare to determine what kind of equipment is eligible for Medicare payment. The definitions and guidelines for the equipment are detailed with the Title XVIII of the The eligibility requirements vary from state to state, but there are lists on government websites that explain what is covered and how.

Durable Medical Equipment Types

This type of equipment includes but is not limited to items like oxygen products, blood-testing strips and blood glucose monitors for diabetics, canes, lifts, potty chairs, and other similar equipment.

Durable Medical Equipment Purpose

This medical equipment is intended to be used in a patient's home or long-term care facility. The long-term care facility must be where a patient lives, like a nursing home or assisted living facility. Durable medical equipment must be a medical necessity for the patient within the home. The equipment cannot be solely needed for recreational use or just for use outside the home. It has to be for required care within the home.

The medical equipment has to be prescribed by a doctor or health care provider. Then the equipment is supplied by a company that specializes in DME equipment. Often this process is coordinated by a home health agency.

Benefits

Durable medical equipment is especially beneficial when a medical condition can be treated at home for a specific amount of time. For instance a patient with a fractured hip might need a life, motorized wheelchair, a potty chair and a walker. Having this equipment allows them to recuperate at home and enhances their quality of life.

Rules and Regulations Governing Durable Medical Equipment

Durable medical equipment has specific rules and regulations governing their use. The use and payment for these products varies from policy to policy. Medicare offers very specific guidelines based on the type of Medicare insurance you have and changing government regulations. Make sure you check your policy and with your doctor before buying or renting the equipment to ensure the best coverage of the costs.

The equipment must be deemed to fill a medical necessity. A doctor or treating practitioner, like a nurse practitioner, physician assistant, or clinical nurse specialist, must prescribe the specific durable medical equipment to be used in your home.

If you have Medicare, a hospital or short-term rehabilitation center does not as a “home.” However a long-term care facility may qualify as your home. So make sure you understand the differences. If you are only in a nursing home or rehab facility to recuperate from an injury, they could be responsible for providing the equipment. Verify with your healthcare provider before accepting or procuring the durable medical equipment.

Summary

Durable medical equipment includes canes, air fluidized beds, commode chairs and patient lifts. It also includes infusion pumps and some of the medicines used in them. Crutches, suction pumps and traction equipment are also considered to be durable medical equipment. Blood-glucose monitors, blood-testing strips and other items needed by diabetics are categorized as durable medical equipment by Medicare.

Make sure you understand you specific policy or Medicare requirements as it relates to durable medical equipment. Make sure you check and get all approvals and conditions in writing before you purchase or buy or rent durable medical equipment. This is especially important with any Medicare Advantage programs.

Again, durable medical equipment can be bought, rented or leased for a specific period of time depending on your insurance or Medicare coverage. This type of equipment is defined as equipment that can be reused.
 
< Prev
You are here  :Home arrow Details arrow Understanding Durable Medical Equipment