Does Medicare Cover Durable Medical Equipment? Complete DME Coverage Guide

Part B also covers durable medical equipment (DME) if the equipment is prescribed by a doctor as needed and purchased from a supplier that is enrolled in Medicare. One of the most widely used Medicare benefits is for equipment, such as wheelchairs, walkers, hospital beds, oxygen equipment, CPAP machines, blood glucose monitors, nebulizers, patient lifts and infusion pumps. Medicare pays 80 percent of the approved amount, and the beneficiaries cover the other 20 percent, after the Part A deductible ($283) has been met. The rules are not as simple as an 80/20 split, however. Some equipment is rented, for a fixed period of time (13 months for capped items, 36 months for oxygen) and some is purchased outright while certain high cost items, such as power wheelchairs, require prior authorization and are subject to a face to face physician exam. To qualify for the program, equipment must satisfy four specific requirements: Long-lasting (can be used for a long time); Medical in function (serves a medical purpose); At home (appropriate for in-home use) and typical useful life (a minimum of 3 years). Replacement – reasonable useful life 5 years.

This guide covers Medicare coverage for durable medical equipment, the cost of DME, the difference between rental vs purchase of DME, and how to get durable medical equipment in 2026. Medicare.gov, CMS and DME supplier guidelines provide information. 

What qualifies as durable medical equipment

Medicare will pay for an item to be considered a DME if it has four characteristics.Items must have four characteristics to be considered DME by Medicare. Equipment should be of high quality and capable of being used repeatedly for a long period of time (usually 3+ years). It must have a medical need and not simply a convenience/comfort need. Not only should it be suitable for the hospital, it should be suitable for the home. Must be prescribed by a Medicare-enrolled physician and have documentation of medical necessity.

Common items that have these criteria and are covered by Medicare include manual wheelchairs, power wheelchair (with different rules for power mobility), walkers and rollators, canes and crutches, patient lifts for transferring from a bed or wheelchair, hospital bed (when medical condition requires bed adjustment for breathing, pressure relief, or position changes), patient lift for transferring between bed and wheelchair or from wheelchair to wheelchair, oxygen equipment and supplies (concentrators, tubing, humidifiers), CPAP and BiPAP machines (for sleep apnea), nebulizers and some non-disposable nebulizer medications, blood glucose monitor and supplies, continuous glucose monitors (CGMs for qualifying patients), infusion pumps and supplies, pressure reducing mattresses and overlays (some require prior authorization), and prosthetics and orthotics.

Home modifications such as widening doorways, fitting a wheelchair ramp, a stair lift or a residential elevator are NOT covered by Equipment Medicare. If the equipment is used outside the house, it's not covered. Comfort or convenience features such as raised toilet seats (unless a medical need), grab bars for the bathtub (unless a medical need), or recline chairs are not covered. Disposable items, such as incontinence pads, bandages, or single-use gloves are not covered (but some types of conditions do qualify). This does not include hearing aids, eyeglasses (apart from after cataract surgery) or dental devices.

For diabetic supplies, check our diabetic supplies guide. 

How Medicare pays for DME: rental vs purchase

Medicare pays differently for various types of DME. This will help you figure out what category you're in, so you can plan for your costs accordingly.

Rental items with caps are rented for 13 months of continuous use, where after you become the owner of the item. These include wheelchairs, hospital beds, patient lifts etc. Once the 13th month is up, monthly rentals cease and you're the owner of the equipment. Once you become the owner, repairs and supplies will be your responsibility, although Medicare may pay for certain maintenance services.

The rental period for oxygen equipment is different from the regular 36-month period. The supplier is required to remain in supply of Equipment and Supplies for the next 24 months after 36 months (total of 60 months). If after 60 months total use, the user still requires oxygen, the supplier or a supplier can start a new rental period for 36 months.

CPAP machines have a 13-month rental period with a mandatory 3-month compliance trial. Medicare may not continue to pay for the equipment if you do not use it enough (usually 4+ hours a night, usually 70% of the time). Transfers ownership after compliance during the trial, and then for the entire 13-month period.

Items routinely purchased are purchased outright. These are walkers, canes, commode chairs, blood sugar monitors and other less expensive equipment. Once bought, you will be the owner of the product.

Customized equipment must be bought not rented as it is specifically made for you. This includes wheelchairs that have extensive modifications, custom-fitted prosthetics and specialized seating systems.

If you need Medicare Part B coverage, you can read more about it in our Part B guide. 

2026 cost breakdown

Under Original Medicare for DME, your 2026 cost structure works as follows. The $283 annual Part B deductible applies once per year before Medicare starts covering its share. After the deductible, you pay 20% coinsurance of the Medicare-approved amount, and Medicare pays the remaining 80%.

The 20% coinsurance can be substantial for expensive equipment. For a $1,500 walker (Medicare-approved amount), your coinsurance is $300. For a $3,000 power wheelchair, $600. For a $15,000+ custom power wheelchair, the coinsurance could exceed $3,000.

Medigap supplement plans cover this 20% coinsurance, which can be valuable protection for beneficiaries needing expensive DME.

The Medicare-approved amount may differ from the supplier's retail price. Suppliers who "accept assignment" agree to Medicare's approved amount as full payment, so you only pay your coinsurance. Suppliers who don't accept assignment can charge more than the Medicare-approved amount, and you may need to pay the difference plus coinsurance.

Some areas have Competitive Bidding Programs for specific equipment like oxygen and power wheelchairs. These programs set payment amounts and require using contracted suppliers, which can affect your supplier choices.

If you have Medicare Advantage, your plan must cover at least the same DME as Original Medicare, but cost-sharing structures and supplier networks vary significantly. Prior authorization requirements may be stricter than Original Medicare. Verify your specific plan's DME coverage before scheduling expensive equipment purchases.

Power mobility: stricter rules

Power wheelchairs and mobility scooters face stricter Medicare coverage rules than manual wheelchairs and walkers due to high costs and historical fraud concerns.

To qualify for a power wheelchair, you must demonstrate that even with the help of a walker, cane, or manual wheelchair, you have significant problems performing daily activities like getting to the toilet, transferring from bed to chair, bathing, and dressing in your home. You must be able to safely operate the equipment yourself or have someone with you to help. Your doctor must conduct a face-to-face examination and document your specific need for power mobility.

For some power mobility equipment, Medicare requires prior authorization before the supplier can provide the equipment. The supplier handles this process by submitting documentation to Medicare, but you may need to provide additional information about your home environment and ability to use the equipment.

Medicare requires that you be unable to use less expensive alternatives (cane, walker, manual wheelchair) before approving a scooter or power wheelchair. The medical documentation must clearly support that less expensive options aren't sufficient for your needs.

Replacement and repairs

For most of the items, the reasonable useful life of DME is 5 years. If your equipment is at the end of its life, after 5 years of use you can request replacements.

Replacement is also provided when you lose, steal or the equipment is irreparably damaged or has reached a high degree of wear before the 5-year mark. Both the replacement criteria and the documentation of the loss or damage are required.

Medicare will typically pay for repairing an item of equipment if you need it but it's damaged.Medicare may cover the price of renting a replacement while equipment is being repaired. This will help avoid breaks in care during maintenance.

If the original supplier is no longer in business or does not have Medicare contracts, you might have to locate an alternative Medicare-enrolled supplier for repairs and maintenance. Original supplier does not have a duty to offer repair services forever.

Patient is responsible for some routine and maintenance cleaning. Filters for CPAPs and oxygen tubing and the like are not typically separately reimbursed beyond the rent or purchase price.