Georgia Medicare Durable Medical Equipment Benefit

In Georgia, Medicare Part B covers durable medical equipment (DME) like wheelchairs, hospital beds, oxygen, and CPAP, and you pay 20 percent of the cost after the deductible.

If you are being discharged from a hospital in Atlanta with a walker, starting home oxygen for COPD in Savannah, moving to a power wheelchair after a Parkinson diagnosis in Macon, or beginning CPAP after a sleep study in Augusta, the same set of rules decides what Medicare pays for, which suppliers can bill Medicare, and what you owe out of pocket. This guide walks a Georgia beneficiary through what qualifies as durable medical equipment, what it costs, how renting and buying work, the extra steps for power wheelchairs and oxygen, how to find a Medicare-enrolled supplier, and what to do if a claim is denied.

In This Guide

• What Counts as Durable Medical Equipment
• What It Costs
• Rent, Buy, and the Capped-Rental Rule
• Power Wheelchairs and Scooters
• Oxygen Coverage
• CPAP and Sleep Apnea Equipment
• Finding a Supplier
• If Medicare Denies Your Claim
• Where to Get Help
• Frequently Asked Questions

What Counts as Durable Medical Equipment Under Medicare in Georgia

Durable medical equipment is reusable medical equipment your doctor or other treating provider orders for use in your home. Medicare Part B covers it, not Part A. (Part A pays for equipment used during a covered hospital or skilled nursing stay as part of the facility bill; equipment for use at home is a Part B benefit.)

To be covered, an item has to meet five conditions: it is durable and can withstand repeated use, with an expected lifetime of at least three years; it is used for a medical reason; it is not generally useful to someone who is not sick or injured; it is appropriate for use in the home; and it is prescribed by a treating provider.1

Common covered items include manual and power wheelchairs, scooters, walkers, canes, crutches, hospital beds, oxygen equipment, CPAP and BiPAP machines, nebulizers, blood sugar monitors and test strips, and continuous glucose monitors. Prosthetic limbs and leg or back braces are a closely related benefit that Medicare pays for under separate prosthetic and orthotic rules, but the coverage and cost-sharing work much the same way for the beneficiary. Lymphedema compression garments and wraps are covered under their own Part B benefit rather than the DME conditions above, though you still get them from a Medicare-enrolled supplier; our guide to Georgia Medicare lymphedema compression item coverage walks through who qualifies, how many garments Medicare pays for, and what you owe.

What Durable Medical Equipment Costs Georgia Medicare Beneficiaries

For most durable medical equipment, you pay the annual Part B deductible, which is $283 in 2026, and then 20 percent of the Medicare-approved amount, as long as your supplier accepts assignment.2,1 A supplier that does not participate in Medicare and will not accept assignment can charge you more, so confirming assignment before you take delivery directly affects your bill.

Several things can cover the 20 percent for you:

• Medigap. Most standardized Medigap (Medicare Supplement) plans pay the 20 percent DME coinsurance.
• A Medicare Savings Program. If you qualify for the Qualified Medicare Beneficiary (QMB) program, participating providers cannot bill you for Medicare cost-sharing at all. In 2026, QMB in Georgia is generally open to a single person with monthly income up to about $1,350.3
• Medicaid. If you have both Medicare and Georgia Medicaid, Medicare pays first and Medicaid may cover the coinsurance and some items Medicare does not.

Medicare Advantage plans must cover at least the same DME as Original Medicare, but they use their own supplier networks, prior-authorization rules, and copays, so check your plan's rules before you order.1

How Medicare Pays: Rent, Buy, and the Capped-Rental Rule

Medicare does not pay for every item the same way. Depending on the equipment, you may rent it, buy it, or choose, and some rented items become your property after a set number of payments.1 Knowing which bucket an item falls into tells you who ends up owning it and who is responsible for repairs.

For capped-rental items, the supplier still has to service and repair the equipment for several years after you own it. If you would rather buy a capped-rental item outright partway through, you can, with credit for the rent already paid.

Getting a Power Wheelchair or Scooter

Power wheelchairs and scooters have the strictest rules of any DME because Medicare has seen the most fraud and overuse in this category. Before Medicare will pay, you must have a face-to-face examination with your treating provider and a written order, and for many models the supplier also has to get prior authorization.1

Here is how it usually goes for a Georgia beneficiary:

• Your doctor examines you, confirms that a cane, walker, or manual wheelchair will not meet your needs at home, and documents why a power device is medically necessary.
• Your doctor writes the order and sends it, with the supporting notes, to a Medicare-enrolled supplier.
• For a power wheelchair that requires prior authorization, the supplier submits the request to Medicare's durable medical equipment contractor and waits for a decision before delivering. Prior authorization confirms coverage up front, so you are far less likely to be stuck with a surprise denial after delivery.

Because the paperwork drives the timeline, the fastest path is making sure the face-to-face exam is documented and the written order is complete before the supplier orders your chair.

Oxygen Coverage and the 36-Month Rule

Home oxygen is one of the most-used DME benefits in Georgia, where chronic lung disease is common among older adults. Medicare covers oxygen equipment when your doctor documents that a qualifying blood-oxygen test and diagnosis show you need it.

Oxygen has its own payment schedule: you rent the equipment from a supplier for a 36-month payment period. After 36 months of rental payments, the supplier still has to keep providing the oxygen and equipment, with servicing, for as long as you medically need it, up to five years from when you started.1 Your doctor has to recertify that you still need oxygen during that time. You pay the usual 20 percent coinsurance on the rental after your deductible.

If you need oxygen away from home, portable oxygen is added to the stationary benefit, and options range from small cylinders to portable concentrators.

CPAP and Sleep Apnea Equipment

Continuous positive airway pressure (CPAP) is the standard treatment for obstructive sleep apnea, and Medicare covers it as a capped-rental item once the diagnosis is documented. Medicare's diagnosis requirement is a clinical evaluation plus a positive sleep study, either an attended polysomnography in a sleep lab or an approved unattended home sleep test.4 A CPAP machine is rented month to month and becomes yours after 13 rental payments; masks, tubing, and filters are replaced on a set schedule.

Medicare covers CPAP in two stages. Coverage starts as a 12-week trial for a beneficiary diagnosed with obstructive sleep apnea, and it continues past those 12 weeks only for beneficiaries who benefit from CPAP during the trial: you meet with your doctor or other provider in person, and they document in your medical record that you meet the coverage conditions and that the therapy is helping.4 Most machines now report usage data to the supplier automatically, so consistent use during those first weeks is what supports that documentation. A BiPAP (bilevel) machine is covered under tighter rules, usually after CPAP has been tried and did not work, or for specific breathing conditions.

Finding a Medicare-Enrolled DME Supplier in Georgia

Medicare only pays for equipment from a supplier that is enrolled in Medicare and holds a Medicare supplier number, so the single most important step is confirming enrollment before you accept anything.1 You can look up and compare suppliers on Medicare Care Compare or by calling 1-800-MEDICARE.

Two things to check with any supplier before delivery:

• Does it accept assignment? A supplier that accepts assignment agrees to Medicare's approved amount, so you owe only your deductible and 20 percent. One that does not can bill you more.
• Is it a contract supplier if it needs to be? Under Medicare's DMEPOS Competitive Bidding Program, some metro areas at times require you to use a contracted supplier for certain items. Most categories are not under competitive bidding in 2026, so you can generally use any enrolled supplier that accepts assignment; if bidding is active for your item in metro Atlanta or Augusta, confirm the supplier holds a contract.

Georgia beneficiaries have national and regional suppliers to choose from, and a hospital discharge planner or your doctor's office can usually point you to one that serves your area.

If Medicare Denies Your DME Claim

If Medicare denies a DME claim, you have the right to appeal, and many denials are overturned when the medical record is completed. Part B DME claims for Georgia are handled by Medicare's durable medical equipment contractor for the region, and the first level of appeal, called a redetermination, goes to that contractor.

The Medicare appeals process has five levels: redetermination, then reconsideration by an independent contractor, an Administrative Law Judge hearing, the Medicare Appeals Council, and finally federal court. Most DME appeals are resolved at one of the first two levels. Watch the deadline on your Medicare Summary Notice, and ask your prescribing doctor to add any documentation the denial says was missing, since a denial is often a paperwork gap rather than a coverage decision. For a step-by-step walkthrough, see our guide on the Georgia Medicare appeals process.

Where to Get Help in Georgia

Free help is available to sort out coverage, find a supplier, or appeal a denial. GeorgiaCares, the state's federally funded counseling program, offers free, unbiased Medicare help to any Georgia beneficiary.5

Learn More

Find personalized help obtaining and paying for durable medical equipment in Georgia at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.