Medicare Part B equipment: what you need to know

When talking about Medicare Part B equipment, the medical supplies and devices that Medicare covers under its Part B medical insurance plan. Also called Part B DME, it includes items like wheelchairs, oxygen tanks, and home‑monitoring tools. Another key player is Durable Medical Equipment (DME), a category of sturdy, reusable devices that improve daily living. To qualify, a doctor must certify medical necessity – meaning the equipment is needed for a diagnosed condition and isn’t just a comfort item. Finally, billing codes such as HCPCS numbers tell Medicare exactly what’s being provided, ensuring proper payment. Together, these pieces create a system where the right gear reaches the right people, and Medicare Part B equipment becomes a lifeline for many seniors.

Key considerations for getting covered equipment

First off, you have to meet the basic eligibility rules: be enrolled in Medicare Part B, have a valid prescription, and prove that the device is medically necessary. The coverage criteria vary by item – oxygen therapy, for example, needs a documented need for oxygen levels below a certain threshold, while a power wheelchair must be prescribed for someone who can’t use a standard chair. Once you have the prescription, you’ll work with a Medicare‑approved supplier. These suppliers verify the HCPCS billing code and submit a claim on your behalf. If the claim is approved, Medicare typically covers 80% of the allowable amount, leaving you with a 20% coinsurance. Some people qualify for a low‑income subsidy that can waive that coinsurance entirely. Keep copies of all paperwork – doctors’ notes, supplier invoices, and claim confirmations – because they’re your best defense if a claim gets denied.

Understanding the billing side can save you headaches later. Claims are processed using specific HCPCS codes; each code maps to a particular piece of equipment and its allowable cost. If a code is entered incorrectly, the claim may be rejected or paid at a lower rate. When a denial happens, you have the right to appeal within 60 days, often by providing additional medical records or correcting the coding error. Many providers also offer a “pre‑authorization” step, where they check with Medicare before shipping the item, which reduces the chance of a denial. Finally, remember that not every device is covered – items considered cosmetic or not essential for health won’t qualify. By staying on top of the eligibility checklist, confirming the right billing code, and keeping thorough records, you’ll increase the odds that your equipment arrives without a billing battle. Below you’ll find a curated collection of articles that break down specific equipment types, real‑world tips for navigating the claims process, and answers to common questions about Medicare Part B coverage.