Medicare Coverage for Durable Medical Equipment (DME)
- DME is coded under Medicare Part B
- After deductible, Medicare pays, 20%
- Client pays 20%
Key Coverage Rules
- If you qualify for hospice, Medi-Cal often pays your Medicare premiums and cost-sharing, ensuring minimal or no out-of-pocket expense
Medi-Cal
(California Medicaid)
- Medi-Cal covers most medically necessary DME and often offers broader coverage than Medicare, including some equipment for community or home use.
Dual Eligibility
(Medi-Medi)
- If you qualify for both Medicare and Medi-Cal, Medi-Cal often pays your Medicare premiums and cost-sharing, ensuring minimal or no out-of-pocket expense.
Simple & Flexible Payment
- Faster Delivery and Setup
- No Prior Authorization Needed
- Special Discounts for Non-Covered Items
Navigating Your Coverage
We understand that insurance can be complex. Our dedicated billing specialists are here to handle the details of verifying and authorizing your coverage, ensuring a smooth and straightforward experience.
Medicare Coverage for Durable Medical Equipment (DME)
- Medicare Part B generally pays 80% of the cost for medically necessary DME after the deductible.
Key Coverage Rules
- Item must be medically necessary
- Item must be prescribed by a Medicare-enrolled doctor
- Item must be appropriate for use in the home
- Client pays 20% co-insurance
Official Government Resources
Access these resources for more detailed information about Medicare and Medi-Cal coverage for DME.
Official Medicare
DME Guide
- Learn about Medicare coverage for DME
Medi-Cal DME Fact Sheet/Forms
- View Medi-Cal fact sheet and forms related to DME
Contact Our
Billing Team
- DME is coded under Medicare Part B
Vital Medical Solutions
Medicare Coverage for Durable Medical Equipment (DME)
Medicare Part B includes coverage for DME. Medicare pays 80% of the cost after your deductible is met.
Key Coverage Rules
Simple & Flexible
Payment
Speedy & private pay: No prior paperwork is required for processing
No prior authorization required. Potential special pricing or discounts for non-covered items.
Medi-Cal
(California Medicaid)
Medi-Cal/Medicaid coverage of DME items, which may extend beyond Medicare to include items for community use.
