Durable Medical Equipment and Medicare: What Part B Covers

Medicare Part B covers durable medical equipment (DME) when it is medically necessary and prescribed for use in your home. After you meet the Part B deductible, you pay 20% of the Medicare-approved amount, as long as the supplier accepts assignment. Walkers, wheelchairs, hospital beds, oxygen equipment, CPAP devices and blood sugar monitors are all on the covered list. The details that decide your bill are the prescription, the supplier and the type of plan you have. This guide walks through each one.

TL;DR

• Original Medicare Part B covers medically necessary DME. After the deductible you pay 20% of the Medicare-approved amount.
• The Part B deductible is $283 in 2026, up from $257 in 2025, according to CMS.
• Use a supplier that is enrolled in Medicare and accepts assignment. That is the main protection against being billed more than the approved amount.
• Medicare Advantage members must follow their plan’s rules, which often mean in-network suppliers and prior authorization.
• A Medicare Supplement (Medigap) plan can cover some or all of the 20% that Original Medicare leaves with you.

Table of Contents

• What counts as durable medical equipment
• What you pay under Original Medicare
• Rent or buy: how Medicare pays
• Wheelchairs, scooters and power mobility
• CPAP and respiratory devices
• Prescriptions, face-to-face visits and why they matter
• Choosing a supplier: the step that protects your wallet
• If you have Medicare Advantage
• How a Medicare Supplement helps with the 20%
• Our perspective
• Get a free review of your coverage
• Frequently asked questions
• Sources

What counts as durable medical equipment

Medicare has a plain definition: DME is reusable medical equipment. To qualify, an item generally has to meet several tests, which Medicare’s DME booklet and the Part B coverage page lay out:

• It is durable, meaning it can withstand repeated use.
• It is expected to last at least 3 years.
• It is primarily used for a medical purpose.
• It is appropriate for use in your home.
• Your doctor or another treating provider prescribes it as medically necessary.

The items most people ask about are hospital beds, walkers, wheelchairs and scooters, home oxygen equipment, CPAP and other respiratory assist devices, and blood sugar monitors. Things that fail the tests are usually items that are not primarily medical (a standard recliner, for example) or that are meant to be used up rather than reused.

Ostomy supplies are a common point of confusion. They are consumable, so they are not a typical reusable DME item, and coverage rules can differ from equipment like a walker. Ask your supplier and your plan which category your specific items fall into before you order, and ask for the answer in writing if the cost is significant.

What you pay under Original Medicare

The cost structure for covered DME is simple on paper:

The deductible and premium figures come from the CMS 2026 Part A and Part B fact sheet. If you want to see how the deductible interacts with the rest of your coverage, our guide to the Part B deductible for Southwest Florida seniors explains it step by step.

A worked example

Suppose you already met your deductible this year and your doctor orders a walker. If the Medicare-approved amount were $100, you would owe $20 and Medicare would pay the rest. That figure is made up to show the arithmetic, not a quote for any item. If you have not yet met the $283 deductible, you would pay the approved amount toward the deductible first, then 20% of whatever approved amount remains after that.

The 20% has no cap in Original Medicare by itself. For an expensive item, such as a power wheelchair, that coinsurance is what surprises people. It is also where a supplement plan earns its keep.

Rent or buy: how Medicare pays

Medicare often pays for DME on a rental basis. For items like wheelchairs and hospital beds, Medicare typically rents them for up to 13 months of continuous use, after which ownership transfers to you, as described in the Medicare DME booklet. During a rental, the supplier is responsible for repairs and replacement parts, and for picking up the equipment when you no longer need it.

One rule matters for rentals. If the supplier does not accept assignment, you may have to pay the full cost upfront and wait for Medicare to reimburse you. For rented items, confirm assignment for every month of the rental, not just the first.

Wheelchairs, scooters and power mobility

Wheelchair questions are some of the most common we hear. Medicare Part B covers wheelchairs and power-operated vehicles (scooters) as DME when the requirements are met. Medicare’s wheelchair and scooter booklet explains the process:

1. A face-to-face visit. The doctor treating your condition examines you to determine whether you need the device for mobility limitations in your home.
2. A written order. For power mobility devices, the physician submits a written order after that exam.
3. A home fit check. The supplier must verify that the equipment will fit in your home, including things like doorway width, before delivery.
4. Prior authorization for certain power wheelchairs. Once affirmed, the authorization is valid for 60 days. The supplier needs to deliver within that window or the process restarts.

The home-use test is why a wheelchair request can be denied even when you clearly have trouble walking. If your difficulty is mostly outside the house, or you could manage in the home with a cane or walker, the paperwork needs to say so honestly and accurately. We cover that angle in Medicare wheelchair coverage in Southwest Florida.

CPAP and respiratory devices

Medicare Part B covers respiratory assist devices if you are eligible. They are classed as DME, so the same rule applies: after the Part B deductible, you pay 20% of the Medicare-approved amount. Eligibility depends on your diagnosis and your provider’s documentation. If you use a CPAP machine, ask your doctor’s office and supplier exactly what documentation Medicare needs and how long they expect it to take.

Prescriptions, face-to-face visits and why they matter

CMS guidance says medically necessary DME must be ordered by a physician or other qualified provider after a face-to-face visit. This is not a formality. It is how Medicare checks that the item fits your actual limitations in the home and cuts down on excessive or inappropriate equipment.

Practical steps before you leave the appointment:

• Tell the provider specifically how the condition limits you at home: getting to the bathroom, getting out of bed, moving between rooms.
• Ask the provider to document those limits in your chart.
• Ask which supplier the office works with, and then check that supplier yourself (next section).

DME also has limits. It will not pay for a caregiver to help you use it, or for the day-to-day help that equipment is often bought to support. A family weighing those costs may find this overview of what Medicare does and does not cover for in-home care useful. It is written from an Arizona perspective, but the federal Medicare rules it describes apply in Florida too.

Choosing a supplier: the step that protects your wallet

The most common mistake is not checking the supplier before the equipment arrives. Medicare Interactive points out that not every supplier is enrolled in Medicare, and that even enrolled suppliers choose whether to accept assignment. Accepting assignment is what limits your bill to the deductible and the 20% coinsurance.

Before you say yes to any supplier, ask these questions:

1. Are you enrolled in Medicare?
2. Do you accept assignment on every claim, including every month of a rental?
3. Do you handle repairs and replacement parts on rented equipment?
4. Will you contact my Medicare Advantage plan for prior authorization (if that applies to me)?
5. What happens if my plan or Medicare changes the supplier list?

You can also search for suppliers with the official tool at Medicare.gov, or call 1-800-MEDICARE (1-800-633-4227).

Competitive bidding can change who is covered

In some areas, Medicare’s DMEPOS Competitive Bidding Program limits coverage for certain items to contract suppliers. CMS’s current timeline shows the next round moving through registration and bidding in late summer or early fall of 2026, with contracts and single payment amounts announced in late summer or early fall of 2027. If you rely on one supplier for ongoing needs like oxygen, check their participation status regularly and watch for notices from Medicare. This matters most for people who relocate, including those who move to Southwest Florida after retiring.

If you have Medicare Advantage

Medicare Advantage members do not follow the Original Medicare process. Your plan sets its own rules, which often include using an in-network supplier and getting prior authorization before the equipment is covered. Medicare’s plan comparison guide notes that you will typically need prior authorization from your plan for certain services and supplies. Going out of network can mean much higher costs or no coverage at all, according to Medicare Interactive.

What to do in practice:

• Call the member services number on your card before ordering anything.
• Ask for the plan’s in-network supplier for the specific item.
• Ask what the copay or coinsurance is for that category of equipment.
• Get the authorization decision in writing.

Device coverage for ongoing conditions can be especially tangled. People managing diabetes with sensors and pumps, for instance, may find it useful to read an explainer on how insurance approval works for diabetic devices before they order. For a side-by-side look at how the two paths differ, see our comparison of Medicare Advantage and Original Medicare in 2026 or the shorter answer on what changed in 2026.

How a Medicare Supplement helps with the 20%

Original Medicare leaves you with 20% of covered DME costs. A Medicare Supplement plan, also called Medigap, is designed to pay some or all of that. Plan G, for example, is a popular choice, though whether it covers the Part B deductible is a question we get often, and we answer it in does Plan G include the Part B deductible. Supplement plans work with any supplier that accepts Medicare, so you are not tied to a network the way you are with many Advantage plans.

Neither choice is right for everyone. A supplement usually means a higher monthly premium and less out-of-pocket exposure. An Advantage plan can mean lower premiums with more rules. Your health, budget, doctors and how much you travel all play into it.

Our perspective

We meet people every week who find out about their DME rules only after the equipment is in the living room. A hospital discharge planner says you need a hospital bed or oxygen by Friday, and the supplier is whoever the hospital called. That is when assignment, network rules and prior authorization suddenly matter.

Our view is that the time to understand this is before you need it. Know whether you have Original Medicare or an Advantage plan. Know what your supplement covers. Keep the number for your plan handy. If you winter in Southwest Florida and live elsewhere the rest of the year, check how your plan treats suppliers and care while you are away from home.

We work with multiple carriers, so we can compare options without steering you toward one company. There is no pressure and no obligation to enroll. Our job is to help you close gaps in your coverage before an emergency exposes them.

— Alston

Get a free review of your coverage

If you are not sure how DME would be paid under your current coverage, we can walk through it with you. We compare Medicare Supplement plans from several carriers and explain Medicare Advantage and emergency transport options in plain language. Consultations are free and carry no obligation, and we serve Fort Myers, Cape Coral, Naples and neighboring counties. For a first look at one gap that people miss, read about emergency transport gaps in Medicare Advantage plans.

Frequently asked questions

Does Medicare cover durable medical equipment?

Yes. Part B covers medically necessary DME for use in your home when a qualified provider prescribes it. After the Part B deductible, you generally pay 20% of the Medicare-approved amount if the supplier accepts assignment. Medicare Advantage plans must cover the same items but can apply their own network and authorization rules.

Does Medicare cover wheelchairs?

Yes, when your treating doctor documents that you need one for use in your home. Power wheelchairs and scooters require a face-to-face exam and a written order. Certain power wheelchairs also require prior authorization, which is valid for 60 days once affirmed.

Will Medicare pay for a CPAP machine?

Medicare Part B covers respiratory assist devices as DME if you are eligible. You pay 20% of the Medicare-approved amount after the deductible. Your provider’s documentation of your condition drives eligibility, so ask the office what Medicare requires.

Are ostomy supplies covered the same way as equipment?

Not necessarily. They are consumable supplies rather than reusable equipment, so the rules and billing can differ from items like a walker. Ask your supplier and your plan, and confirm the supplier is enrolled in Medicare before you order.

Can I choose any supplier?

With Original Medicare, choose a supplier enrolled in Medicare that accepts assignment. In some areas, competitive bidding limits certain items to contract suppliers. With Medicare Advantage, use your plan’s in-network suppliers.

Sources

• Medicare.gov: Durable medical equipment (DME) coverage
• Medicare.gov: Medicare Coverage of DME and Other Devices (booklet)
• Medicare.gov: DME booklet, rental details
• Medicare.gov: Medicare Coverage of Wheelchairs and Scooters
• Medicare.gov: Respiratory assist devices
• Medicare.gov: Compare types of Medicare Advantage plans
• Medicare Interactive: DME supplier basics
• CMS: 2026 Medicare Parts A and B premiums and deductibles
• CMS: DMEPOS Competitive Bidding Program updates

Recommended

• Medicare and Respiratory Care Coverage: 2026 Guide
• Ground Ambulance and Medicare: What Coverage Looks Like
• Medicare Wheelchair Coverage in Southwest Florida: Check Home Use
• What Does Emergency-Medical-Transportation Coverage Cover?