Durable Medical Equipment (DME) is a device that provides therapeutic benefits to patients in need because of certain medical conditions and/or diseases. Durable Medical Equipment (DME) consists of goods that:
- mainly and usually used to serve medical purposes;
- is of no use to a person without illness, disability, or injury;
- ordered or determined by a doctor;
- can be reused;
- can be used repeatedly, and
- suitable for home use.
DME includes, but is not limited to, wheelchairs (manual and electrical), traction equipment, sticks, crutches, pedestrians, kidney machines, ventilators, oxygen, monitors, pressure mattresses, lifts, nebulizers, biliary blankets and billiards.
Similar criteria are used by Medicare and Medicaid.
- (n) The term "durable medical equipment" - DME - including, but not limited to, wheelchairs (manual and electrical), hospital beds, traction equipment, sticks, crutches, kidney machines, ventilators, oxygen, monitors, pressure mattresses, elevators, nebulizers, bili quilts and billiards.
The insurance company will provide cover for Long Term Medical Equipment when medically determined is necessary because the medical criteria and guidelines for its use are met.
Durable medical equipment may be covered when All of the following criteria are met:
- 1. This equipment provides therapeutic benefits to patients in need because of certain medical conditions and/or diseases; And
- 2. The DME is determined by a licensed provider; And
- 3. The DME does not function primarily as a convenience or convenience item; And
- 4. The equipment has no significant non-medical use (eg, environmental control equipment, air conditioning, air filters, and air humidifiers).
Durable Medical Equipment and Services are not covered when..
- The DME add-on or upgrade is intended primarily for convenience or upgrades beyond what is necessary to meet the legitimate medical needs of that member. Examples include: decorative items, unique materials (eg magnesium wheelchairs, lights, extra batteries, etc.) *; or
- When not providing therapeutic benefits to patients in need due to certain medical conditions or illnesses; or
- When the DME has not been determined by a licensed provider; or
- When DME functions primarily as a convenience or convenience item. Trays, backpacks, wheelchair racing equipment are examples of items not covered or comfort items *; or
- When equipment is used in the facility expected to provide the goods to the patient; or
- When devices and equipment are used to improve environmental settings (eg air conditioning, air humidifiers, air filters, portable Jacuzzi pumps, or chair lifts used for up and down stairs). This is not primarily medical and will not qualify for coverage *; or
- For equipment delivery and preparation services, education and training for patients and families, as well as nursing visits, are not eligible for a separate replacement regardless of lease or purchase agreement.
- For DME add-ons or enhancements intended primarily for member/carer comfort, or that do not significantly increase DME functionality. *
Video Durable medical equipment
See also
- Certificate of medical needs
- Home medical equipment
- Medical devices
- Increased patient
- Transfer bench
- Medical equipment
- Credit cabinet
- Lift up the chair
Maps Durable medical equipment
References
Source of the article : Wikipedia
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