What You Should Know About Durable Medical Equipment

By TRICARE
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Falls Church, Va, August 4, 2015 - Durable Medical Equipment (DME) is any equipment for beneficiary use that helps them live a better quality of life. DME, covered by most health insurances, is also covered by TRICARE when ordered by a TRICARE-authorized provider.

To be considered DME, the equipment must be medically necessary and reusable. TRICARE covers the cost of medical supplies when related directly to a covered medical condition and when those supplies are obtained from a medical supply company, a pharmacy, or an authorized provider.

DME can be rented or purchased, but your regional contractor will determine which is most appropriate for your situation. The contractor will consider your prescription, your current medical condition, and the amount of time you will need the DME. TRICARE will pay for the replacement of a medically required DME that you own if your medical condition changes or equipment malfunction because of reasonable wear and usage. If you accidentally damage a DME that you have purchased and the manufacturer's warranty has expired, TRICARE will also cover the cost of repairs or replacement costs.

Two popular examples of prescribed DME are walkers and continuous positive airway pressure (CPAP) machines. Recently, TRICARE added breast pumps and breast pump supplies to its list of DME. No matter the type of breast pump you are considering, keep the cost in mind--do you need a luxury model or the basic model? The kind of breast pump you chose is important because the covered amount is a pre-negotiated rate between TRICARE and the DME provider. TRICARE will typically pay the lesser of the negotiated cost.

For more information, please visit the Durable Medical Equipment page on the TRICARE website.