Funding Sources for Durable Medical Equipment (DME) – Part 1

Getting funding is probably the biggest challenge that patients and caregivers face when dealing with a sudden traumatic injury or illness, or the need for a loved one to receive special care requiring durable medical equipment (DME), such as wheelchair ramps for home.

The first thing to remember is that you don’t have to pay for this completely out of your own pocket. There are several different funding sources to consider when making a durable medical equipment (DME) purchase.

Private Health Insurance/Medicare

If you have private health insurance, probably as a benefit at your workplace, most plans cover at least a percentage of the cost of durable medical equipment (DME). You’ll have to review the details of your plan to get the specifics for coverage.

After age 65, another option is to enroll in Medicare. Medicare Part B does cover durable medical equipment (DME) that a doctor prescribes for you to use in your home. Some of the DME it does cover include (but is not limited to):

• Hospital beds
• Wheelchairs and other mobility devices
• Patient lifts
• Traction equipment
• Walkers

Medicaid

Medicaid is a joint, federal, and state program that helps with medical costs for some people with limited income and resources. How it is administered and what it covers varies from state to state. For example, in Massachusetts, Medicaid is combined with the Children’s Health Insurance Program (CHIP) under the banner MassHealth, however, in Rhode Island, the program is named Rhode Island Medical Assistance.

Veterans Benefits

There are many programs that are specifically for individuals who have served in the armed forces provided by the Department of Veterans’ Affairs. One example is TRICARE, supplemental health insurance for elderly and retired members of the armed forces and their families. Another is CHAMPVA, a program that provides health insurance for individuals over 65 who are family members of permanently disabled veterans or those killed in the line of duty.

Another program that helps veterans purchase durable medical equipment (DME) is the Veterans Directed Home and Community Based Services (VD-HCBS). This is a program managed at a local VA center to help veterans with a care budget take care of their medical needs by selecting the services and supplies that they need.

This is the end of part 1 of Funding Resources for Durable Medical Equipment (DME), stop back again next month for part 2.

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