Durable Medical Equipment

As you get older, you may find it more difficult to comfortably complete daily tasks.

Trouble getting in and out of the shower may be one issue you have trouble with each day. It is also possible for you to develop medical conditions that can impair your ability to walk or limit the use of your arms or hands. For example, you may suffer such symptoms from arthritis. Alternatively, you may have such problems when recovering from an injury, such as a broken bone.

When recovering from injuries or suffering from permanently impaired mobility due to aging, you may wish to continue living independently. However, whether living alone or with a family member, you will need special tools to make home life easier for you. Many of those assistive devices are forms of durable medical equipment (DME). Below is more information about durable medical equipment, including which types are covered by insurance.

Durable Medical Equipment

Understanding how durable medical equipment is defined is essential for determining your needs. Not every type of medical device or supply is considered DME. To be classified as a form of DME, a piece of equipment must be usable in a home setting. As the name suggests, it must also be durable and long-lasting. Supplies like catheters, for example, are single-use items and are therefore not considered DME. However, items like lift seats are forms of DME because they’re intended to be permanent.

There are many types of DME available for home use, but it is important to understand they fall in two distinct categories. One group of DME is essential equipment, which is considered medically necessary for you, such as a wheelchair. Essential DME will be recommended by your doctor. The other group of DME optional, but likely to make you more comfortable when you perform daily activities. One such device is a bath bench. Deciding whether to obtain optional DME is entirely up to you or your caregiver.

Durable Medical Equipment Designed for Mobility Assistance

A mobility issue is one of the biggest obstacles you may face when trying to continue living at home as you get older. If you cannot walk, or have difficulty walking, some or all areas of your property may be inaccessible to you, unless you get the proper types of medical equipment to assist you. Even if you can technically walk without using such a device, you may have a condition that impairs your motor control or balance. In such an instance, DME can help you reduce the risks of falling in your home.

According to the National Council on Aging, one senior citizen dies from a fall approximately every 19 minutes. To avoid becoming one of the many seniors injured or killed by falls, you will need mobility assistance devices. Such tools are commonly known as ambulation devices. They include:

  • Walkers.
  • Canes.
  • Crutches.
  • Motorized scooters.
  • Wheelchairs.

If you think you need one of the devices above, you cannot buy the first one you see without risking injury. You must consult your doctor. He or she can fit you for such a device to make sure it is comfortable and fully functional. For example, when recovering from a leg injury, you may need crutches. Crutches are available in multiple lengths. Therefore, you must obtain crutches appropriate for your height so you can use them without injuring yourself further.

Other Types of Durable Medical Equipment

Although ambulatory assistance devices make up a large portion of the available DME you can use at home, they are far from the only devices available. The medical device market includes devices to help you in many ways inside your home. Many such devices are designed to make using the toilet and the bathtub or shower easier and safer for you. They include:

  • Portable bidets.
  • Safety bars.
  • Bath chairs.
  • Bath benches.

You can also obtain DME to assist you in other parts of your home. For example, a breathing machine may be necessary to help you breathe at night while you are sleeping. Other types of devices you can use throughout your home include:

  • Lifts.
  • Trapeze bars.
  • Heating pads.

Obtaining Durable Medical Equipment

You can purchase durable medical equipment from any seller of medical assistance devices. However, purchasing such devices on your own can be quite expensive. By speaking to your doctor, you can get medical proof of your need for some types of DME. Doing so may qualify you for partial or total coverage of the DME costs by your insurance. You can also opt to rent DME instead of purchasing it. That option may make the most sense if you only require it temporarily, such as when recovering from an injury.

Durable Medical Equipment Covered by Insurance

The type of medical insurance you have will impact the list of covered DME from which you can pick. However, the typical rule of thumb is most essential forms of DME are generally covered. Non-essential types of DME are usually not. For example, Medicare will not cover convenience items like:

  • Over bed tables.
  • Home elevators.
  • Bed lifters.
  • Bathtub lifts.
  • Grab bars.

Also, you may be required to rent most DME to receive insurance coverage. For example, if you are a Medicare recipient, your coverage will only pay for you to rent most forms of DME. Additionally, your Medicare coverage will only pay those rental fees for a limited time period. That period will be calculated based on the purchase cost of the item. The few exceptions covered for purchase under Medicare include:

  • Inexpensive items.
  • Common items, such as canes.
  • Items that cannot be resold or rented because they must be customized to suit your needs.

If you already own a piece of durable medical equipment but it is broken, you may also qualify for insurance assistance. The Medicare program will typically pay 80 percent of the approved purchase amount to help you repair the item. You will be required to pay the difference. However, the medical equipment supplier must accept assignment for that coverage to take effect.

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