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Medically Modern

Coverage

Does Medicare Cover Durable Medical Equipment?

Often, yes. Original Medicare Part B covers qualifying equipment when it's medically necessary, ordered by your treating provider, and supplied by a Medicare-enrolled supplier. You generally pay 20% of the Medicare-approved amount after the Part B deductible. Ask us and we will check before you order. Here is how Medicare coverage works for the equipment and supplies we deliver across New York.

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The short answer

Original Medicare Part B covers qualifying durable medical equipment when it is medically necessary and prescribed, and, under a separate benefit, eligible lymphedema compression items. A prescription alone doesn't guarantee coverage. Original Medicare doesn't cover adult diapers, and generally doesn't cover ordinary support stockings or knee scooters. Medicare Advantage plans may differ. What your specific coverage looks like, and what paperwork it asks for, depends on the item - ask us and we will check your benefits first.

CPAP and lymphedema compression through Medicare

Two of the most common Medicare orders we see are CPAP machines and supplies, and compression garments for lymphedema. Original Medicare has covered lymphedema compression garments since January 1, 2024, when they are prescribed - up to 3 daytime garments per body area every 6 months and up to 2 nighttime garments per body area every 2 years (CMS Medicare Learning Network MM13286; Social Security Act section 1861(s)(2)(JJ)). If you need either, leave your name, phone, and email and we will follow up.

How ordering works

Every order moves through the same four steps: get the order, verify benefits, complete documentation, and arrange delivery. We deliver in-stock items anywhere in New York State, typically in 2-5 business days after your order is ready to ship. We'll confirm timing for other items. Our store is in Mount Kisco if you would rather talk in person.

What to have ready

Have your prescription and your Medicare card handy when you reach out. We check your benefits and your expected out-of-pocket cost before anything is ordered - benefit information is an estimate, not a guarantee of payment.

Related

Answers

Medicare questions

Original Medicare may cover a CPAP machine and supplies for diagnosed obstructive sleep apnea after a qualifying sleep test, starting with a 12-week trial. The Part B deductible and 20% coinsurance apply. See our CPAP page for details, or ask us to check. Benefit information is an estimate, not a guarantee of payment.

Yes - Original Medicare has covered compression garments for lymphedema when prescribed since January 1, 2024. Standard allowances are 3 daytime garments per body area every 6 months and 2 nighttime garments per body area every 2 years. Medicare Advantage plans may differ. Tell us what the prescription calls for and we will match the garment to it.

Original Medicare covers wheelchairs and walkers for use in your home when medical-necessity requirements are met, but generally doesn't cover knee scooters. Other plans vary. Ask us and we will check.

Yes. We deliver in-stock items anywhere in New York State, typically in 2-5 business days after your order is ready to ship. We'll confirm timing for other items.