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
Medicare defines durable medical equipment as equipment that meets all of the following criteria:
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.
Medicare Part B covers a broad range of medically necessary DME when ordered by a physician. Covered items include:
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.
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.
Medicare's approach to acquiring DME depends on the item's cost and type:
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.
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.
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.
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:
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.
| 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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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.