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What medical supplies and equipment does Medicare Part B cover?

Navigating the complexities of Medicare can often feel like learning a second language. One of the most critical components for beneficiaries to understand is Medicare Part B, which acts as your medical insurance. While Part A covers hospital stays, Part B is responsible for outpatient services, including the “tools” you need to manage your health at home or in a clinical setting.

Broadly speaking, Medicare Part B covers two main categories of supplies: Durable Medical Equipment (DME) and related medical supplies. Understanding the criteria for coverage is essential to ensuring your claims are approved and your out-of-pocket costs are minimized.

The Core of Coverage: Durable Medical Equipment (DME)

Medicare defines Durable Medical Equipment as equipment that meets several specific criteria. To be covered under Part B, the item must be:

  • Durable: Able to withstand repeated use.

  • Medical: Used for a medical reason.

  • Necessary: Not useful to someone who isn’t sick or injured.

  • Home-based: Used in your home (this can include long-term care facilities, but generally not a hospital or skilled nursing facility).

  • Long-lasting: Expected to last at least three years.

Common Examples of Covered DME

If your doctor prescribes them for use in your home, Medicare Part B typically covers:

  • Mobility Aids: Wheelchairs, scooters, walkers, canes, and crutches.

  • Life Support & Oxygen: Oxygen equipment and accessories, as well as nebulizers and associated medications.

  • Monitoring Equipment: Blood sugar monitors and continuous glucose monitors (CGMs).

  • Furniture/Safety: Hospital beds, patient lifts, and pressure-reducing beds or mattresses.

  • Respiratory Assist Devices: CPAP (Continuous Positive Airway Pressure) machines for sleep apnea.

Medical Supplies and Preventative Tools

Beyond large equipment, Part B also covers specific supplies that are either “consumable” or used in conjunction with a medical procedure.

Diabetes Supplies

Medicare is quite robust regarding diabetes management. Under Part B, you are covered for:

  • Blood sugar test strips and lancet devices.

  • Glucose control solutions.

  • Insulin pumps (and the insulin used in those pumps).

  • Note: Standard insulin not used with a pump is typically covered under Medicare Part D (Prescription Drug Plans).

Wound Care and Surgical Dressings

If you have a surgical wound or a primary injury that requires professional debridement or specific dressing changes, Part B covers the necessary surgical dressings. However, standard “first aid” supplies like common adhesive bandages or gauze for minor cuts are generally not covered.

Prosthetics and Orthotics

Part B covers certain prosthetic devices to replace a body part or function, such as:

  • Artificial limbs.

  • Breast prostheses (including a surgical bra) after a mastectomy.

  • One pair of eyeglasses or contact lenses following cataract surgery.

  • Orthopedic shoes (only if they are a necessary part of a leg brace).

The “Supplier” Catch: Avoiding Surprises

Perhaps the most important rule of Medicare Part B coverage is where you buy your supplies. To ensure Medicare pays its share, both your doctor and your medical supply provider must be enrolled in Medicare.

More importantly, you should look for “participating” suppliers that “accept assignment.” This means the supplier agrees to accept the Medicare-approved amount as full payment. If a supplier does not accept assignment, they can charge you more than the Medicare-approved price, leaving you to pay the difference.

Costs to You

Typically, once you meet your Part B deductible, you pay 20% of the Medicare-approved amount for the equipment or supplies. Medicare pays the remaining 80%. Depending on the item, you may be required to rent the equipment, buy it, or you may have a choice.

Helpful Resources

To verify if a specific item is covered or to find a supplier near you, utilize these official resources: