Durable medical equipment: What’s covered and how to get it

(Aging Untold) — Walkers, wheelchairs and hospital beds can help older adults stay independent, but navigating the system to obtain durable medical equipment is often complicated and confusing.

Figuring out what to order, what’s covered and the costs can be overwhelming.

What qualifies as durable medical equipment

Durable medical equipment, or DME, covered by Medicare or other insurance must be obtained from a company that works with that insurer, Amy O’Rourke, an aging expert, said. A doctor’s order is required.

Examples include quad canes with four prongs on the bottom and CPAP machines for people who have difficulty breathing.

O’Rourke recommended the Medicare.gov website to clarify what’s covered. She said people often don’t think to check if what they need will be paid for by insurance.

“Very rarely is it not covered, but if it’s not, look for secondhand medical supply stores or local communities that might have something that you need,” O’Rourke said.

She said one woman borrowed a walker from a neighbor because the woman thought using the Medicare system meant taking something from someone else.

“Don’t think that,” O’Rourke said. “It’s something that helps maintain independence.”

Overcoming stigma around medical equipment

Sam Cradduck, a gerontologist, said durable medical equipment is reusable and many people view it as a symbol of decline.

“It’s not. It’s a tool to protect you,” Cradduck said.

She said many people don’t want others to see them using a walker because they fear looking old or frail.

“Well, I’d rather people see me as dependent than see me on the floor,” Cradduck said.

She added that shame tied to aging prevents people from using equipment that could help them.

Dr. Rhea Rogers, a board-certified physician, said the equipment can serve as a temporary aid to help people recover.

“It can be in between you needing help right now to get you back on your feet, so it’s not necessarily permanent,” Rogers said.

The delivery and training gap

Rogers said doctors write prescriptions and rely on hospital staff to handle the rest, but that doesn’t always happen.

Durable medical equipment companies often drop off equipment without providing instruction, Cradduck added.

“They’re going to show up. They’re going to drop it off. They’re going to say, here, sign for this. And they’re walking away,” Cradduck said.

She said walkers may not be adjusted to the right height and patients may not know how to operate oxygen concentrators or tanks.

Cradduck said patients need to seek instruction from physical therapy and occupational therapy staff or find a caregiver who knows how to use the equipment.