No matter what form these tools take — from simple canes to high-tech insulin pumps — they support and strengthen our health, our independence, and our overall quality of life. That’s why DME coverage is included in CalPERS health plans.
What Is Durable Medical Equipment?
According to federal regulations, DME is defined as medically necessary equipment that:
- Is durable — can withstand repeated use
- Is primarily and customarily used to serve a medical purpose
- Isn’t generally useful to someone without an illness or injury
- Is appropriate for home use
- Is expected to last three years or more
Examples of DME that follow this federal definition include:
- Prosthetics and orthotics
- Canes and crutches
- Wheelchairs and power scooters
While disposable or temporary items like bandages aren’t considered DME, certain supplies that are needed to work with the DME items or devices are covered. Think of:
- The disposable lancets and test strips needed for blood sugar monitors.
- The oxygen used for home or personal portable tanks.
- The medications used with nebulizers for respiratory treatments.
DME Coverage Is Included in CalPERS Health Plans
Because of DME’s vital importance to your holistic health and well-being, CalPERS Basic and Medicare plans include durable medical equipment coverage. Learn more with your plan’s Evidence of Coverage booklet or contact your health plan directly.
If you feel you may have a medical condition that could benefit from DME, talk to your doctor or primary care provider. They can help determine what equipment you may need and can also recommend nearby providers where you can get the equipment, plus guidance on how to use it effectively and safely.
And an important note: Since DME is considered medically necessary, your provider may need to write you a prescription so you can get the equipment and any required supplies.
For questions about CalPERS health plans, services, and coverage, contact your provider or plan, or call us at 888 CalPERS (or 888-225-7377).