4 steps to buying durable medical equipment
If you're dealing with a health condition or recovering from surgery that requires durable medical equipment (DME), you may find yourself wondering where to get medical equipment and if insurance covers it. DME is typically used to help you do things that you might be unable to do because of medical circumstances. It might be something you use temporarily or for a lifelong condition.
The good news is, your health insurance typically covers durable medical equipment.
Some of the most common types of DME are:
- Wheelchairs
- Walkers
- Breast pumps
- Oxygen equipment
- Insulin pumps
But, getting medical equipment and making sure it's covered according to your health insurance coverage isn't quite as simple as showing up at the store and making the purchase.
The most common covered durable medical equipment:
- Oxygen equipment
- Walkers
- Breast pumps
- Insulin pumps
- Wheelchairs
That's why it's important to follow these 4 steps.
1.
Get a prescription from your doctor
Just like you need a prescription for medication, durable medical equipment also requires a prescription to be covered by your health insurance. It's essential to applying your health insurance coverage to DME. Talk to your doctor about what you might need, based on your condition. If you're pregnant and need a breast pump, for example, consider getting the prescription from your doctor a few weeks ahead of your due date, so you have the script in-hand at the hospital on delivery day.
2.
Check your DME coverage and cost share
After you get a prescription, check your coverage in myWellmark® to confirm the equipment meets coverage requirements and see if there may be a copay or coinsurance. To see your durable medical equipment coverage, look under “H” for Home/Durable Medical Equipment or check your coverage manual, which can be found in the Resources box.
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3.
Find an in-network DME provider
It’s important to make sure the durable medical equipment (DME) you choose comes from an in‑network provider. You can easily find an in-network DME provider by searching for 'durable medical equipment' under facility type. Using covered DME from an in‑network provider is the simplest way to avoid unexpected costs and get the most from your benefits.
4.
Contact the provider to get your DME
At this point, contact your in‑network DME provider to get your equipment. They can help you understand whether the equipment will be purchased or rented and what your costs may be. Because these details are specific to your plan, working with both your DME provider and Wellmark Customer Service can help you get the most from your DME benefits.