Durable Medical Equipment and Supplies

Durable Medical Equipment and Supplies

Durable Medical Equipment (DME)

Durable medical equipment (DME) must be prescribed by your attending provider and determined by BCBSMS to be medically necessary for treating your illness or injury, or to prevent further deterioration. It is recommended to get prior approval from BCBSMS.

To be covered, DME must be made to withstand repeated use, primarily serve a medical purpose (not for comfort or convenience), generally not be useful without illness or injury, and be appropriate for use in your home.

Benefits for DME are based on the allowable charge for basic equipment. For any deluxe item, benefits will be limited to the allowable charge for the basic version. If special features are medically necessary to maintain or promote mobility or function, BCBSMS may approve those features.

DME can be rented or purchased, whatever is determined best by BCBSMS. Rental fees cannot exceed the cost of purchasing the item. A DME claim must include a letter from your provider explaining the medical necessity.

Medical Supplies

Medical supplies such as splints, casts, trusses, braces, syringes, needles, catheters, and colostomy bags and supplies are covered based on medical necessity.

Prosthetic or Orthotic Devices

Covered services include the purchase and initial placement of prosthetic or orthotic devices, and their fitting, repair, or replacement when medically necessary. Shoe buildup, orthotic, brace, or support is not covered unless the shoe is attached to a brace.