Home Medical Equipment: Understanding Coverage and the Best Equipment for You

insurance coverage home medical

In 2014, spending for durable medical equipment (DME) in the United States broke $46.4 billion. Insurance providers received and filed millions of claims seeking coverage – but how do they decide which cases deserve assistance?

Most insurance providers’ criteria for DME coverage asks that supplies be:

  • Durable (long-lasting)
  • Used for a medical reason
  • Not typically useful to someone who isn’t sick or injured
  • Able to restore and maintain standard quality of living

With that criteria, select versions of items like CPAP devices, crutches, and manual wheelchairs fit the bill. However, a host of assistive devices don’t qualify as medically necessary – think grab bars, knee walkers, tub benches, lift chairs, bed assist handles, and over bed tables.

Without the help of insurance, DME can place a heavy financial burden on ailing individuals. As you search for health supplies not covered by insurance, ask yourself these questions to save money where possible, courtesy of the professionals at HomePro Medical Supplies:

Do I have the option to rent? If your medical equipment is needed for a temporary instead of permanent condition, consider renting instead of buying supplies. Wheelchairs for rehabilitation, portable oxygen concentrators for long-distance travels, and home monitoring systems for post-surgery care may be rented for a smaller fee than you’d pay for purchasing.

Have I researched all funding options? Finances extend beyond insurance and personal savings. Each state offers varying levels of assistance to elderly and disabled individuals, providing funds for medical equipment separate from Medicaid assistance. A number of non-profits and foundations at both the local and national level extend funds for specific ailments, ranging from prosthetics for amputees to shower chairs for Muscular Dystrophy patients. In certain cases, your home medical equipment can be claimed with Dependent Care Tax Credit or Medical and Dental Expense Tax Credit.

Even if it’s covered, is it my best option? Not all products within the same category are treated equally. While your insurance provider may cover a selection of neck braces, for example, they may not cover the brace option you’ve found to be the most effective. Save your co-pay on an option that doesn’t meet your needs and invest it instead in the supplies that truly makes a difference for you.

Do I truly need this? If insurance didn’t deem it medically necessary, evaluate if you should do the same.  Assistive items should drastically improve your quality of life, and you can save money by purchasing only supplies that meets a significant need.

The professionals at HomePro Medical Supplies can help you find the quality, best-fit equipment you need at the price you can afford. Don’t hesitate to contact us for answers or assistance.