Medicare durable medical equipment coverage runs through Part B and pays for the everyday gear that makes living at home possible. The rules are more specific than most people expect, though: wheelchairs, walkers, hospital beds, oxygen, and CPAP machines are all covered, but only under the right conditions. The equipment has to meet five criteria, your doctor has to order it, and what you finally pay turns on one word most people never hear until the bill arrives: assignment. This guide covers what's covered, what it costs in 2026, and how to avoid the supplier mistakes that leave people with a surprise bill.

What counts as Medicare durable medical equipment

Durable medical equipment, or DME, is reusable medical gear meant for use in your home. Part B is the part of Medicare that covers it, the same part that handles doctor visits and outpatient care.

For Medicare to treat something as durable medical equipment, it has to check all five of these boxes:

  • It's durable, meaning it can withstand repeated use.
  • It's used for a medical reason.
  • It generally isn't useful to someone who isn't sick or injured.
  • It's used in your home.
  • It's expected to last at least three years.

Meeting those five is only half of it. Part B covers medically necessary DME only when a doctor or other treating provider orders it for use in your home, and Medicare tells beneficiaries to make sure both that provider and the supplier are enrolled in Medicare. A doctor's order isn't a formality you can skip, it's the thing that turns a piece of equipment into a covered benefit.

What Medicare covers as DME

The category is broad. Some of the most common items Medicare covers as durable medical equipment:

If you're wondering whether a specific item qualifies, the test is the five criteria above, plus medical necessity. Your doctor and supplier can confirm coverage for your exact item before you commit.

What Medicare durable medical equipment costs in 2026

DME follows the standard Part B cost structure, so if you've dealt with Part B before, this will look familiar.

What you pay 2026 amount Notes
Part B annual deductible $283 You pay this first, once per year
Your share after the deductible 20% of the Medicare-approved amount Only if the supplier accepts assignment; otherwise you may be charged more
Part B premium $202.90/month (standard) The ongoing premium that keeps Part B active

So the pattern is this: you meet the $283 Part B deductible for the year, and after that you pay 20% of the Medicare-approved amount for your equipment while Medicare covers the remaining 80%. A Medigap (Medicare Supplement) policy, if you have one, can pick up that 20%.

Read that 20% as a floor rather than a fixed price, because it holds only when the supplier accepts assignment. A supplier that doesn't participate in Medicare and won't accept assignment may charge you more than the approved amount, and the difference is yours. On rented equipment the stakes are higher still: if the supplier isn't willing to accept assignment for all the rental months, you have to pay the full cost of the equipment upfront and wait for Medicare to reimburse you. That is the difference between a $60 monthly share and a four-figure cheque on delivery day, so ask about assignment for every month before you sign.

The supplier rule that catches people off guard

This is where DME goes wrong for people, so it's worth slowing down on. Medicare's instruction to beneficiaries is to make sure your doctors and DME suppliers are enrolled in Medicare, and the consequence Medicare states for using one who isn't enrolled or won't accept assignment is that you can be charged more. Treat enrollment and assignment as the two questions that decide your bill, and ask both before the equipment is ordered rather than after it's delivered.

You may also run across Medicare's DMEPOS Competitive Bidding Program, which normally sets payment rates for widely used items and steers you to a Medicare contract supplier that has agreed to accept assignment on every claim for a bid item. It isn't operating at the moment. The last round of contracts, covering off-the-shelf back braces and knee braces, expired December 31, 2023, and Medicare has been in a temporary gap period since January 1, 2024, with a future round posted for 2028. So for now, Medicare enrollment is the supplier test that matters, and no item requires a contract supplier.

Two habits protect you here:

  • Before you accept any equipment, ask whether the supplier is enrolled in Medicare and accepts assignment. A supplier that accepts assignment agrees to the Medicare-approved amount, which keeps your share at the standard 20%.
  • Be wary of any supplier that contacts you out of the blue, especially by phone, offering "free" equipment. Unsolicited DME offers are a common source of both non-covered bills and outright fraud.

How to find a Medicare-enrolled supplier

You don't have to guess whether a supplier qualifies. Medicare.gov tells beneficiaries to make sure their doctors and DME suppliers are enrolled in Medicare, and you can check before you order.

Medicare Supplier Directory Search by ZIP code and equipment type to find suppliers enrolled in Medicare, and see which ones accept assignment. Then ask the supplier itself what you will owe: if it accepts assignment you pay 20% of the Medicare-approved amount after the Part B deductible. medicare.gov/medical-equipment-suppliers
1-800-MEDICARE The official Medicare contact line for beneficiaries and the route CMS gives for an Original Medicare question. You can talk or live chat with a real person 24 hours a day, 7 days a week, except some federal holidays. 1-800-633-4227, TTY 1-877-486-2048

Rent or buy? It depends on the item

Medicare doesn't handle every piece of equipment the same way. Some DME is covered as a rental, some as a purchase, and for some items you get a choice. Oxygen equipment, for example, is rented for a set 36-month payment period rather than bought outright.

You usually don't have to manage this yourself, the supplier and Medicare's rules determine which applies to your item. But it's useful to know so the arrangement doesn't surprise you, particularly with oxygen, where the rental structure is built into how the benefit works. Some items also become your property after a certain number of rental payments, so a long rental can quietly turn into ownership.

When Medicare has to approve the equipment first

Prior authorization isn't only a Medicare Advantage thing, and assuming otherwise is a good way to have a claim denied on a technicality. CMS keeps a Master List of DMEPOS items that may be subject to a face-to-face encounter, a written order, and/or prior authorization, and a shorter Required Prior Authorization List. For everything on that second list, prior authorization is a condition of payment: no approval, no payment.

Certain types of power wheelchairs need prior approval, and any power wheelchair or scooter also requires a face-to-face examination and a written prescription from your treating provider. If a scooter or power chair is what you're after, that exam is the first appointment to book, not an afterthought.

The lists move, so check rather than assume. CMS announced in July 2026 that 20 codes join the Master List effective October 28, 2026, and eight codes join the Required Prior Authorization List, including certain orthoses, a pressure reducing support surface, and a manual wheelchair base. Prior authorization begins nationwide on October 28, 2026 for four orthoses codes, one pressure reducing support surface, and one manual wheelchair base. Two upper limb orthoses phase in more slowly: October 28, 2026 in California, Florida, Michigan and New York, then January 26, 2027 adding Arizona, Georgia, Illinois, Massachusetts, Ohio, Oregon, Pennsylvania and Texas, and nationwide on April 26, 2027.

One reason two suppliers may tell you different things: since June 1, 2026, suppliers that demonstrate billing compliance with a provisional affirmation rate of 90% or higher can qualify for an exemption from required prior authorization, under a rule CMS issued in December 2025. So ask your supplier whether your item needs prior authorization and whether they're handling the submission.

What to do if Medicare denies your DME claim

A denial isn't the end of the road. Medicare gives you a formal appeal, and DME denials are often reversed once the paperwork is right. Here's the path.

1
Step 1

Read your Medicare Summary Notice

Your quarterly Medicare Summary Notice (MSN) lists every claim and, for anything denied, the reason. Start there so you know whether the problem was a missing doctor's order, a non-enrolled supplier, or a coding issue.

2
Step 2

File a redetermination

Ask for the first level of appeal, called a redetermination, generally within 120 days of the date on your MSN. Circle the items you're appealing on the notice, add a short note and any supporting records from your doctor, and follow the mailing instructions printed on the MSN.

3
Step 3

Escalate if you're still denied

Medicare's appeals process has five levels. If the redetermination doesn't go your way, the notice you receive explains how to take it to the next level, so you can keep pressing if the equipment is medically necessary.

If you have Medicare Advantage

If you're on a Medicare Advantage (MA) plan instead of Original Medicare, you still get DME coverage. Plans have to cover all the medically necessary Part A and Part B services Original Medicare covers, and durable medical equipment is one of them.

The differences are in how you get it. Medicare Advantage plans use their own supplier networks, and you may need prior authorization, meaning the plan's approval, before they'll cover a piece of equipment. Check your plan's rules before ordering, since going outside the network can leave you paying more or paying everything.

Frequently Asked Questions

Does Medicare cover a CPAP machine?

Yes. A CPAP machine for sleep apnea is covered as durable medical equipment under Part B, as long as it's prescribed by your doctor and you use a Medicare-enrolled supplier. After the 2026 Part B deductible of $283, you pay 20% of the Medicare-approved amount when the supplier accepts assignment; without assignment you may be charged more.

Why won't Medicare pay for my equipment?

The most common reasons are a missing or incomplete doctor's order, equipment that doesn't meet Medicare's definition of DME, or an item on the Required Prior Authorization List that went out without the prior authorization Medicare requires as a condition of payment. All five criteria have to be met and the item has to be medically necessary. If you think a denial is wrong, you can appeal it, starting with a redetermination.

What does "accepts assignment" mean for DME?

A supplier that accepts assignment agrees to charge only the Medicare-approved amount. That keeps your cost at the standard 20% share. A supplier that doesn't accept assignment may charge more, leaving you to pay the difference.

Is DME a rental or a purchase?

It depends on the item. Medicare covers some equipment as a rental, some as a purchase, and lets you choose for others. Oxygen equipment is rented for a 36-month payment period rather than bought.

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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.

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Brevy Care Team

Expert eldercare guidance from Brevy's team of healthcare professionals and researchers.