Durable Medical Equipment (DME) Coverage

I learned from our therapist that therapy equipment, formula, and diapers can be covered through Medicaid as Durable Medical Equipment (DME) coverage if it is a medical necessity for the disabled child.  

Equipment that DME Covers (but isn’t limited to):

·        Blood sugar monitors

·        Braces (leg, arms, back, neck)

·        Canes

·        Crutches

·        Diapers

·        Feeding Pumps

·        Formula

·        Home oxygen equipment

·        Medical beds

·        Orthotics

·        Prosthetic devices

·        Therapeutic shoes and inserts

·        Walkers

·        Wheelchairs

Coverage depends upon age of child and need. For medical equipment, a therapist or doctor will examine child to see if medical equipment would benefit the child. If a need is established, the child will get a script.

For diapers and formula, some states start coverage at age three and other states start coverage at age four. Once you find out your child is of need and age to be covered, you must then get a script from your pediatrician or family practitioner to show that it is a medical necessity.

After you obtain a script, you would need to contact Medicaid to find a supplier. The supplier must be enrolled in Medicare. Some states have a website for their DME General Directory. I have also heard that some states allow you to purchase online (make sure you check with your state first). Your doctor or therapist might also be able to help you find a provider.

We were very blessed when both of our children required medical shoes and inserts. Our Physical Therapist evaluated our children, wrote the script, and even ordered them for us through a DME provider. We then picked up the shoes and inserts through our therapy clinic. I know that this doesn’t happen for everyone.  Some special needs parents have to do all of the work themselves.

Knowing about DME coverage can really help with medical expenses for your special needs child. Having a child with special needs can be very expensive. Every little bit of help can make a big difference!