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Durable Medical Equipment Under Medicare

Durable medical equipment (DME) is equipment that is designed to provide a therapeutic benefit to a patient who certain health conditions or illnesses. Most Medicare DME is covered under Part B although sometimes Part A will pay for item when you are in a hospital setting.

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 Here are some of the most common DME items:

  • Hospital beds, canes, walkers, crutches and commode chairs

  • Wheelchair and power mobility devices

  • Nebulizers and the medications used in them

  • Home Oxygen equipment and accessories

  • Sleep Apnea devices and accessories

  • Infusion pumps and supplies

  • Blood glucose monitors and test strips for diabetes self-testing

  • Incontinence products, catheters & more

  • Braces such as Medicare back brace or Medicare knee brace

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Step One: Schedule an Office Visit with your Provider

Your first step in getting DME is to start with your doctor. Medicare will not pay for Durable Medical Equipment unless specifically prescribes a piece of equipment for a health condition or injury.

Medicare wants to see that you have had an office visit with your doctor during which your needs for DME are discussed. When your doctor writes the order for the DME, he must give the date of the doctor visit, which cannot be more than 6 months prior to the date you order the equipment.

Step Two: Find an Approved Medicare DME Supplier

  • We can do that for you.

Insurance Participation

DME Supplies existence and development was based on offering the durable medical equipment (DME) to include but not limited to patient care aids, sleep therapy, oxygen, and other respiratory products at discounted prices due to high deductibles, coinsurance, no insurance, and sometimes simply needed extras not covered by insurance.  Medicare, Medicaid, nor any insurance payer participant and does not have a a National Provider Identifier (NPI) number to bill on behalf of our customers. Please see How to Bill Your Health Insurance Guide by DME Supply. 
 Most of our customers visit our site for cost savings on out of pocket expenses; some aren't sure where to go or how to get their DME supplies through insurance. We are definitely here to help in any way we can while disclosing the full scope of our services and products along with other options available to our customers.
If you are a Medicare beneficiary or covered by any other insurance payer, We will help no out of pocket for your DME supplies.                                                                                            Email us:  service@tribalenterprisesllc.com

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             Special Requirements for Certain DME Items

Some items are more expensive and therefore they require special rules. Wheelchairs are an example:

Your doctor’s order must state that it’s very hard for you get around in your own living quarters even if with a cane or walker. You must also be having significant issues with regular daily living activities such as dressing or bathing. When your doctor prescribes the wheelchair, he must list the date that your office visit took place and give his opinion that you are able to safely use the wheelchair.

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Power scooters are another item that have special DME rules. When your doctor prescribes a scooter, you must order the scooter within 45 days of his prescription.  His order will have to stipulate that you have the same problems listed above for getting a wheelchair. However, the order must also stipulate that you can’t use a manual wheelchair but could safely use a powered one.

Please note that some states have additional rules and required forms for wheelchairs and scooters. Check with your doctor to be sure you follow those rules.

Replacing DME

Medicare will only replace durable medical equipment that has been in your possession for its entire lifetime and is at least five years old. If you have an item that is worn down, contact your supplier to find out the process to have them replace it.

Please contact us if you have insurance we can put you in the system and and if needed Doctor's name for authorization. We can bill your insurance and set you up on recurring monthly deliveries, if needed for convenience. Email us with type of Insurance and provider name & number and please leave a phone number as a back up, we may need to contact and verify by phone.                     

                                   Service@tribalenterprisesllc.com 
           

                                     The Affordable Care Act 
               American Indians and Alaska Natives

For American Indians and Alaska Natives, the ACA will help address health disparities by investing in prevention and wellness and increasing access to affordable health coverage.

The ACA provides American Indians and Alaska Natives with more choices; depending on your eligibility and the coverage available in your state, you can:

  • Continue to use IHS, tribal, and/or urban Indian health programs

  • Enroll in a qualified health plan (QHP) through the Marketplace

  • Access coverage through Medicare, Medicaid, and the Children's Health Insurance Program

If you choose to enroll in a QHP through the Health Insurance Marketplace plan, you may qualify for special benefits and protections offered to American Indians and Alaska Natives.

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                          Helpful Information for Native Americans    

     Medicare Medicaid & CHIP for American Indians and Alaska Natives

Medicaid and the Children’s Health Insurance Program (CHIP) are available to qualifying federally recognized American Indians and Alaska Natives. These programs provide better access to services that a local Indian health clinic might not be able to provide.

You can apply for Medicaid or CHIP even if you filed for an exemption from the shared responsibility payment.

To learn how to apply for these programs, visit our Medicaid & CHIP page.

More:

https://www.cms.gov/Outreach-and-Education/American-Indian-Alaska-Native/AIAN

 

https://www.cms.gov/Outreach-and-Education/American-Indian-Alaska-Native/AIAN/Marketplace

 

https://www.cms.gov/files/document/indian-healt-service-cms-all-final.pdf

 

https://www.cms.gov/Outreach-and-Education/American-Indian-Alaska-Native/AIAN/State-Tribal-Relations-on-Health-Care#bookmark2

 

https://www.cms.gov/Outreach-and-Education/American-Indian-Alaska-Native/AIAN/State-Tribal-Relations-on-Health-Care#bookmark2

 

https://www.cms.gov/Outreach-and-Education/American-Indian-Alaska-Native/AIAN/State-Tribal-Relations-on-Health-Care#bookmark3

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Contact us if you need recurring monthly delivered Medical supplies: service@tribalenterprisesllc.com
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