Understanding DME: What Equipment Is Covered by Insurance?
Understand Durable Medical Equipment (DME) coverage — what Medicare, Medicaid and private insurance cover for home medical equipment.
If you or a loved one needs a CPAP machine, a wheelchair, or home oxygen, one of the first questions is usually: will insurance pay for this? The good news is that most durable medical equipment (DME) is covered by Medicare, Florida Medicaid, and major private insurers when it's medically necessary and prescribed by a doctor. Here's how coverage actually works in South Florida, and what's typically included.
What Counts as Durable Medical Equipment?
DME is equipment that's reusable, used for a medical reason, and appropriate for use in the home — think CPAP machines, wheelchairs, hospital beds, and oxygen concentrators. To qualify for insurance coverage, equipment generally needs to be prescribed by a physician and supplied through an accredited, in-network provider like AHCEQUIP.
Medicare Coverage for DME in Florida
Medicare Part B covers DME that's medically necessary and ordered by a Medicare-enrolled physician. After the annual Part B deductible, Medicare typically pays 80% of the approved amount, with the remaining 20% covered by supplemental insurance or Medicaid. Commonly covered items include CPAP/BiPAP machines and supplies, home oxygen equipment, hospital beds, wheelchairs, walkers, and nebulizers. You can review Medicare's official DME rules directly at Medicare.gov.
Florida Medicaid Coverage
Florida Medicaid covers many of the same DME categories as Medicare for qualifying patients, including CPAP and BiPAP therapy, home oxygen, wheelchairs, walkers, commodes, and hospital beds. Coverage details vary by plan, and most Medicaid-managed plans require prior authorization — AHCEQUIP's referral team handles this directly with the plan before scheduling delivery. For official guidance, see the Florida Agency for Health Care Administration (AHCA).
Private Insurance in South Florida
AHCEQUIP is in-network with most major private insurers serving Broward, Miami-Dade, Palm Beach, and Monroe counties, including Aetna, Cigna, Florida Blue, and UnitedHealthcare. Most commercial and Medicare Advantage plans cover DME when it's medically necessary, though some categories require prior authorization before equipment can be delivered.
What's Covered, By Category
Sleep Health (CPAP & BiPAP)
CPAP and BiPAP machines, masks, tubing, filters, and humidifier chambers are covered under most Medicare, Medicaid, and private plans following a qualifying sleep study. Supplies are typically eligible for resupply on a set schedule — see our guide on when to replace CPAP supplies and how Medicare covers CPAP in 2026. Learn more about AHCEQUIP's sleep health services.
Respiratory Care
Home oxygen concentrators, portable oxygen, and nebulizers are covered when prescribed for a qualifying respiratory condition and ordered through an accredited supplier. Visit our respiratory care page for details on setup and ongoing support.
Mobility & Daily Living
Manual and power wheelchairs, walkers, rollators, hospital beds, and commodes are generally covered when medical necessity is documented and the equipment meets plan-specific criteria. See our full range of medical equipment for home use.
How to Verify Your Coverage Before Ordering
Before any equipment is delivered, AHCEQUIP's referral team verifies your specific plan, checks prior authorization requirements, and confirms what you'll owe out of pocket — so there are no surprises. If you have a prescription or referral, our team can usually confirm coverage within one business day.
Frequently Asked Questions
Does Medicare cover CPAP machines and supplies?
Yes. Medicare Part B covers CPAP machines, masks, and supplies after a qualifying sleep study, subject to the annual Part B deductible and 20% coinsurance.
Does Florida Medicaid cover wheelchairs?
Yes, for patients who meet medical necessity criteria. Most Medicaid-managed plans require prior authorization, which AHCEQUIP handles directly with the plan.
Do I need a prescription to get insurance-covered DME?
Yes. Insurance plans require a written order or prescription from a physician, and in some cases additional documentation like a sleep study or face-to-face encounter notes.
What if my insurance isn't listed?
AHCEQUIP works with most major Medicare, Medicaid, and commercial plans in South Florida. Contact our team and we'll verify your specific plan and benefits.
How long does insurance verification take?
In most cases, AHCEQUIP can confirm coverage and any prior authorization requirements within one business day of receiving your prescription.
Have questions about your specific plan? Reach out to AHCEQUIP and our team will help you understand exactly what's covered.
