What Is Medicare's Policy Regarding Medical Equipment Replacement?


Quick Answer

Medicare typically replaces beneficiary-owned, medically necessary durable medical equipment with an identical or nearly identical item if the equipment experiences irreparable damage or loss, according to Noridian Healthcare Solutions. Medicare might replace equipment that has irreparable wear or that is stolen, except in cases of malicious damage or neglect.

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Full Answer

Medicare's replacement policies distinguish between equipment that requires replacement due to irreparable damage and those that require replacement because of irreparable wear, notes Noridian Healthcare Solutions. Items damaged by a specific accident or a natural disaster are considered irreparably damaged and eligible for replacement.

Requests to Medicare for replacement of items due to irreparable wear, which is deterioration as a result of long-term, day-to-day usage, must take into consideration the equipment's reasonable useful lifetime, notes Noridian Healthcare Solutions. During the equipment's useful lifetime, Medicare does not cover the cost of complete replacement. However, during a piece of equipment's reasonable useful lifetime, Medicare covers the costs of repairs up to the cost of actual replacement.

Medicare Part B provides coverage for medically necessary durable medical equipment that a health care provider prescribes for the patient's use at home, according to Medicare.gov. Examples of Medicare-covered medical equipment include hospital beds, blood glucose monitoring machines, walkers and crutches.

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