The hospital discharge planner says you will need a walker, a hospital bed, and eventually oxygen at home. Someone hands you a supplier's business card, equipment arrives, and weeks later a bill shows up that does not look like what anyone described. Durable medical equipment — DME — is one of the areas where Medicare's rules are strict in ways that catch people off guard: the equipment has to meet a definition, the order has to come from the right person, the supplier has to be enrolled in Medicare, and whether you rent or own depends on which payment category the item falls into. Here is how the benefit works in 2026.
What Counts as Durable Medical Equipment
Medicare Part B covers DME when it meets all of these conditions:
- Durable — it can withstand repeated use
- Used for a medical reason, ordered by a treating provider
- Not generally useful to someone who is not sick or injured
- Used in your home (a nursing home may count as your home; a hospital or skilled nursing facility generally does not)
- Expected to last at least three years
Commonly covered items include walkers, canes, crutches, manual wheelchairs and power wheelchairs and scooters, hospital beds, patient lifts, commode chairs, oxygen equipment and supplies, nebulizers, suction pumps, infusion pumps, and CPAP devices. Blood sugar monitors, test strips, and continuous glucose monitors are also handled through the DME benefit — see our guide to diabetes supplies and equipment.
What is generally not covered: items considered convenience or comfort rather than medical necessity. That category typically includes grab bars, most bathroom safety equipment, air conditioners, and — in most situations — stair lifts. Disposable supplies are usually excluded unless they are used with covered equipment.
The Order and the Supplier
Two requirements drive most DME denials, and both are administrative rather than medical.
A written order from a Medicare-enrolled prescriber. Your doctor, nurse practitioner, physician assistant, or clinical nurse specialist must document that the item is medically necessary. Certain items — power mobility devices among them — also require a face-to-face visit documenting your need before the order is written.
A supplier enrolled in Medicare with a supplier number. If the company that delivers your equipment is not enrolled, Medicare will not pay the claim, no matter how legitimate the medical need. Beyond enrollment, ask one more question before anything is delivered:
- "Do you accept assignment?" Suppliers who accept assignment agree to Medicare's approved amount as payment in full and may bill you only for the deductible and coinsurance.
- A supplier who does not accept assignment may charge more than the Medicare-approved amount, and there is no limiting charge for DME the way there is for doctors' services. You may also be asked to pay the full amount up front and wait for reimbursement.
You can look up enrolled suppliers, including which ones accept assignment, at medicare.gov/medical-equipment-suppliers.
What You Pay in 2026
Under Original Medicare, DME follows standard Part B cost sharing:
- $283 annual Part B deductible must be met first
- 20% coinsurance of the Medicare-approved amount after that, with no annual cap under Original Medicare
- Medigap policies generally cover that 20% coinsurance, depending on the plan letter
In a Medicare Advantage plan, the plan sets its own cost sharing — often a percentage for DME — and typically requires you to use suppliers in the plan's network. Those costs count toward the plan's out-of-pocket maximum, which cannot exceed $9,250 in-network in 2026. Prior authorization is common for higher-cost equipment; our guides to prior authorization and the 2026 rule changes explain how those reviews work.
Rent or Buy: Who Ends Up Owning It
Medicare assigns each DME item to a payment category, and the category — not your preference — determines whether you rent or purchase.
Capped rental items (hospital beds, most wheelchairs, and similar equipment): Medicare pays monthly rent for up to 13 months of continuous use, after which ownership transfers to you and the rental payments stop. You continue paying 20% of each rental payment along the way.
Inexpensive or routinely purchased items (walkers, canes, and other low-cost equipment): these may be rented or purchased outright, often at the supplier's discretion.
Oxygen equipment follows its own rule: Medicare pays rent for up to 36 months, but the supplier keeps ownership. After the 36-month cap, the supplier must continue furnishing the equipment for the remainder of its five-year reasonable useful lifetime. You keep paying for oxygen contents if you use tanks or cylinders, and maintenance visits are covered on a set schedule. At the end of the five years, you may start a new rental period with the same supplier or switch.
Repairs and replacement: Medicare may cover repairs to equipment you own, and replacement when an item is lost, stolen, damaged beyond repair, or has reached the end of its reasonable useful lifetime — generally five years.
Competitive Bidding: Where Things Stand
For years, Medicare used a competitive bidding program that required people in designated areas to use contracted suppliers for certain equipment. There is currently no active bidding round. CMS finalized updated program rules effective January 1, 2026, but has said the next round of contracts will not begin until January 1, 2028, and it has identified additional supply categories — including ostomy, tracheostomy, and urological supplies — that could be included then.
The practical effect for 2026: you may generally use any Medicare-enrolled supplier, which makes it worth calling more than one and comparing what each charges and whether they accept assignment.
If a Claim Is Denied
DME denials frequently trace back to documentation — a missing face-to-face note, an order that does not spell out medical necessity, or a supplier enrollment problem. Steps that often help:
- Ask for the denial reason in writing and check your Medicare Summary Notice for the specific code
- Ask your prescriber to supply the missing documentation, which resolves many denials without a formal appeal
- File an appeal if the denial stands — our guide to appealing a Medicare decision walks through the levels and deadlines
How to Get Help and Learn More
- Medicare.gov — Coverage details and the supplier directory are at medicare.gov/coverage/durable-medical-equipment-dme-coverage.
- 1-800-MEDICARE (1-800-633-4227) — Medicare's helpline can confirm whether a specific item is covered. TTY users can call 1-877-486-2048.
- State Health Insurance Assistance Program (SHIP) — SHIP counselors offer free, unbiased help with DME denials and billing questions. Find your local program at shiphelp.org.
Summary and Next Steps
- DME must be durable, medically necessary, used in your home, and expected to last at least three years
- You need a written order from a Medicare-enrolled prescriber and a Medicare-enrolled supplier
- Under Original Medicare you pay the $283 deductible and 20% coinsurance in 2026; Medigap may cover the 20%
- Ask whether the supplier accepts assignment before delivery — DME has no limiting charge protection
- Capped rental items convert to your ownership after 13 months; oxygen is rented for 36 months with the supplier retaining ownership
- There is no active competitive bidding round in 2026; the next round of contracts is scheduled to begin in 2028
Before equipment is delivered, ask three questions: Are you enrolled in Medicare? Do you accept assignment? Is this item rented or purchased? The answers determine most of what you will pay.
