Billing Policy | Insurance Terminology | Medicare DME Coverage
Participating Insurance Plans | Payment Options | Rentals

Statement Sample

Understanding Medicare Coverage for DME:

Patients with Medicare Part B benefits have coverage for most durable medical equipment and supplies. The coverage is based on medical necessity for each item.

Medicare determines the allowable fee amount for each item. Of that amount, Medicare will pay 80%. The 20% balance transfers to the patient or the patient's secondary insurance plan. If the patient does not have a secondary insurance plan, he is responsible for the full 20% payment.

Medicare has an annual deductible of $147 for 2015. This amount may or may not be covered by your secondary insurance.

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