Medicare Coverage for Durable Medical Equipment in Florida 2026

By the Florida Plan Finder Team · Licensed Florida Health Insurance Producer · NPN #21249133 · Last Updated: May 2026

Key Takeaways

Medicare Part B covers durable medical equipment at 80% after the $257 deductible — you pay 20% coinsurance with no annual cap unless you have Medigap.
You must use a Medicare-enrolled DMEPOS supplier — buying from a non-enrolled supplier means Medicare pays nothing.
Medicare typically rents equipment for 13 months before ownership transfers to you; small items under $150 are purchased outright.
Prior authorization is required for certain high-cost items — including power wheelchairs over $1,000 and some pressure-reducing support surfaces.
Medigap Plan G eliminates the 20% DME coinsurance, providing full coverage for approved equipment after the annual deductible.
Comfort items like grab bars and non-medical bath chairs are NOT covered by Medicare — regardless of physician recommendation.

Durable medical equipment (DME) covers a wide range of items that help Medicare beneficiaries manage health conditions at home — from wheelchairs and walkers to oxygen concentrators and CPAP machines. Understanding what Medicare covers, how cost-sharing works, and how to find an approved supplier saves Florida seniors significant money and prevents claim denials. This guide explains everything you need to know about DME coverage under Medicare in 2026.

In This Guide

What Qualifies as DME
What Medicare Covers
Cost and Cost-Sharing
Renting vs. Buying
Finding Approved Suppliers
Prior Authorization Requirements
Common DME Coverage Table

What Qualifies as Durable Medical Equipment

Medicare defines durable medical equipment as equipment that meets all of the following criteria:

Durable: Expected to withstand repeated use and last at least three years.
Medical purpose: Used primarily to serve a medical need — not for comfort or convenience.
For home use: Intended for use in the patient's home, not in a clinical setting.
Medically necessary: Ordered by a physician and supported by documentation of a medical condition requiring the equipment.
Not disposable: Reusable items — not single-use supplies, though supplies used with covered DME (like CPAP masks or test strips) are often also covered.

Items that are comfortable but don't meet the medical purpose standard — like bath chairs for general safety, raised toilet seats without a specific medical need, or grab bars installed for convenience — are not covered by Medicare DME benefits, regardless of whether a physician recommends them for safety.

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What DME Does Medicare Cover?

Medicare Part B covers a broad range of medically necessary DME when ordered by a physician. Covered items include:

Mobility equipment: Manual wheelchairs, power wheelchairs, power-operated scooters, walkers, rollators, crutches, and canes — when medically necessary and documented.
Hospital beds: Electric or manual hospital-style beds for home use, including mattresses and bed rails, when medically necessary (e.g., positioning requirements for a medical condition).
Oxygen equipment: Oxygen concentrators, compressed oxygen cylinders, liquid oxygen systems, and related supplies including tubing, cannulas, and regulators — when oxygen saturation criteria are documented.
CPAP and BiPAP machines: Continuous positive airway pressure machines for obstructive sleep apnea diagnosis, plus replacement supplies including masks, tubing, filters, and humidifier chambers on a CMS replacement schedule.
Blood glucose monitors: Glucose meters for insulin-treated diabetics, plus lancets, lancet devices, and test strips. Continuous glucose monitors (CGMs) are also covered under Part B for qualifying beneficiaries.
Nebulizers: Compressor nebulizers and related medication administration supplies for beneficiaries with COPD or asthma requiring nebulized medications.
Prosthetics and orthotics: Prosthetic limbs and eyes, braces and orthotic devices for arms, legs, back, and neck when medically necessary following injury, surgery, or due to a chronic condition.
Infusion pumps: External infusion pumps and related supplies for drug delivery at home.

Medicare Part B pays 80% of the Medicare-approved amount for covered DME after you have met the annual Part B deductible of $257 in 2026. You are responsible for the remaining 20% coinsurance. There is no annual out-of-pocket cap on DME under Original Medicare — meaning DME costs accumulate without limit unless you have supplemental coverage.

No Out-of-Pocket Cap for DME Under Original Medicare Unlike Medicare Advantage plans which have a maximum out-of-pocket limit, Original Medicare has no annual cap on DME coinsurance. If you need expensive equipment like power mobility devices or oxygen concentrators, the 20% coinsurance can be substantial. Medigap Plan G or Plan N eliminates or reduces this exposure.

Medigap plans that cover Part B coinsurance — primarily Plan G and Plan N — will pay the 20% DME coinsurance. Plan G covers 100% after the annual Part B deductible. Plan N covers 100% except for certain office visit copays that do not apply to DME billing. This makes Medigap particularly valuable for beneficiaries who rely on ongoing DME supplies like CPAP equipment, oxygen, or diabetic testing supplies.

Medicare Advantage plans provide the same DME coverage as Original Medicare but require you to use in-network DMEPOS suppliers. Out-of-network suppliers may result in higher cost-sharing or denied claims. Always verify supplier network status with your MA plan before ordering equipment.

Renting vs. Buying — How Medicare Handles DME Acquisition

Medicare's approach to acquiring DME depends on the item's cost and type:

Inexpensive or routinely purchased items (under $150): Medicare pays to purchase these outright. Canes, simple walkers without wheels, and similar items fall in this category.
Capped rental items ($150 and above): Medicare rents the equipment for up to 13 continuous months. After 13 months of rental, ownership transfers to you — the beneficiary. Ongoing maintenance and repairs (for 36 months after transfer) remain the supplier's responsibility. CPAP machines, standard power wheelchairs, and many other items follow this rental pathway.
Oxygen equipment: Medicare rents oxygen equipment and pays for 36 months. After 36 months, the supplier must continue to provide equipment and supplies without additional charge for as long as they are medically necessary.
Custom items: Custom-fabricated prosthetics and orthotics are purchased, not rented, because they are specific to the individual.

Understanding the rental period is important for planning. If you move to a Medicare Advantage plan mid-rental period, your new plan takes over the rental obligation — but supplier network changes may complicate the transition.

Finding Medicare-Approved Suppliers in Florida

This requirement trips up many beneficiaries: you must obtain DME from a supplier enrolled in Medicare's DMEPOS Supplier Program. Purchasing from a non-enrolled supplier — including many online retailers, big-box stores, or discount medical supply shops — means Medicare will not cover the claim. You would pay 100% out of pocket and cannot submit for reimbursement.

How to Find an Approved Supplier Use the Supplier Directory at medicare.gov to search for Medicare-enrolled DMEPOS suppliers in your Florida ZIP code. Filter by equipment type. You can also call 1-800-MEDICARE to get a referral. Your physician's office can often provide a referral to enrolled suppliers they work with regularly.

Florida's major metro areas — Miami-Dade, Broward, Palm Beach, Hillsborough, Orange, and Duval counties — have abundant DMEPOS suppliers. Rural counties in North Florida and the Panhandle may have fewer local options, but many enrolled suppliers will ship equipment to your home and handle billing remotely.

Florida is included in CMS's DMEPOS competitive bidding program, which covers urban areas including Miami, Tampa, Orlando, and Jacksonville metros. Under competitive bidding, CMS selects suppliers based on competitive pricing — which can affect which specific suppliers are authorized to bill Medicare for certain equipment categories in those markets. In competitive bidding areas, you must use a contract supplier for the covered item or pay out of pocket.

Prior Authorization for High-Cost DME

Medicare requires prior authorization (PA) for certain high-cost or frequently abused DME categories before it will approve payment. As of 2026, prior authorization is required for:

Power mobility devices (power wheelchairs and power-operated scooters) with an estimated cost over $1,000
Pressure-reducing support surfaces (Group 2 and Group 3 support surfaces for wound care)
Certain other high-cost items identified by CMS on an ongoing basis

For power wheelchairs specifically, Medicare requires a face-to-face examination by a physician, a detailed written order, and supporting documentation of medical necessity before submitting the PA request. The process typically takes several weeks. Work with your physician and DMEPOS supplier to initiate the PA process before the equipment is ordered.

Common DME Items — Medicare Coverage and Cost-Sharing

Equipment Item	Medicare Covers?	Acquisition Method	Your Cost (Original Medicare)
Standard manual wheelchair	Yes	Capped rental (13 months then own)	20% coinsurance after deductible
Power wheelchair / scooter	Yes (PA required over $1,000)	Capped rental (13 months then own)	20% coinsurance after deductible
Walker / rollator	Yes	Purchase (under $150) or capped rental	20% coinsurance after deductible
Cane	Yes	Purchase	20% coinsurance after deductible
Hospital bed	Yes (if medically necessary)	Capped rental (13 months then own)	20% coinsurance after deductible
CPAP / BiPAP machine	Yes	Capped rental (13 months then own)	20% coinsurance after deductible
CPAP supplies (mask, tubing)	Yes	Purchase on replacement schedule	20% coinsurance after deductible
Oxygen concentrator	Yes	Rental (36 months, then continued)	20% coinsurance after deductible
Blood glucose monitor	Yes	Purchase	20% coinsurance after deductible
Test strips / lancets	Yes (insulin-treated diabetes)	Purchase on replacement schedule	20% coinsurance after deductible
Nebulizer	Yes	Capped rental (13 months then own)	20% coinsurance after deductible
Prosthetic limb	Yes	Purchase (custom fabricated)	20% coinsurance after deductible
Grab bars / handrails	No	N/A — comfort item	Not covered
Non-medical bath chair (no skilled need)	No	N/A — comfort item	Not covered

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Frequently Asked Questions

How much does Medicare pay for a CPAP machine in Florida?

Medicare covers CPAP machines and supplies under Part B. After meeting the $257 Part B deductible in 2026, Medicare pays 80% of the approved amount and you pay 20% coinsurance. Medicare typically rents the CPAP machine for 13 months, after which ownership transfers to you. Supplies like masks and tubing continue to be covered on a replacement schedule.

Can I buy medical equipment directly and have Medicare reimburse me?

Only if you purchase from a Medicare-enrolled DMEPOS supplier. If you buy equipment from a supplier not enrolled in Medicare — including many online retailers — Medicare will not reimburse you. Always verify that your supplier is enrolled in Medicare before purchasing equipment you plan to bill to Medicare.

Does Medicare cover power wheelchairs and mobility scooters?

Yes, Medicare Part B covers power wheelchairs and power-operated scooters when medically necessary and prescribed by a physician following a face-to-face examination. Power mobility devices over $1,000 require prior authorization from CMS before Medicare will approve the claim. You pay 20% coinsurance after the Part B deductible.

Does Medigap cover the 20% DME coinsurance?

Yes. Medigap plans that cover Part B coinsurance — such as Plan G and Plan N — cover the 20% DME coinsurance. Plan G covers 100% of the coinsurance after the Part B deductible. Without Medigap, there is no annual out-of-pocket cap on DME costs under Original Medicare.

Does Medicare cover grab bars and home safety modifications?

No. Grab bars, non-medical bath chairs, ramp installations, and other home safety modifications are not covered by Medicare Part B as DME — they are considered comfort or convenience items. Some Medicare Advantage plans offer a supplemental home safety benefit that may cover some modifications. Contact your plan directly to ask.

Licensed Florida Health Insurance Producer · NPN #21249133Information on this page is for general reference and is updated regularly. Verify current plan availability and costs at HealthCare.gov before enrolling.