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Does TRICARE cover durable medical equipment (DME)?
Verified by TRICARE.com Editorial Team
Updated 2024-12-01
AI-assisted (gemini)
Quick Answer
TRICARE covers DME like wheelchairs, CPAP machines, and prosthetics when prescribed by a provider and authorized as medically necessary.
Key Takeaways
- DME covered when medically necessary
- Prior authorization usually required
- Network suppliers save money
- Prosthetics and repairs included
Detailed Answer
Durable Medical Equipment (DME) is covered when medically necessary for treatment.
Covered DME Examples
- Wheelchairs and scooters
- Hospital beds
- CPAP and BiPAP machines
- Oxygen equipment
- Walkers and canes
- Prosthetics and orthotics
- Blood glucose monitors
- Nebulizers
- Breast pumps
Authorization Required
- Most DME needs prior authorization
- Provider submits request
- Medical necessity reviewed
- Approval before obtaining equipment
Rental vs Purchase
- TRICARE determines rental or buy
- Some items always purchased
- Rental may convert to purchase
- Maintenance may be covered
Where to Get DME
- Network DME suppliers
- MTF (some equipment)
- Non-network with higher costs
Prosthetics and Orthotics
- Prosthetic limbs covered
- Custom orthotics covered
- Repairs and replacements included
- Fitting and adjustments covered
Related Questions
What services does TRICARE cover?
TRICARE covers preventive care, doctor visits, hospitalization, surgery, mental health, maternity, prescriptions, and more with some requiring authorization.
What services require prior authorization?
Prior authorization is needed for many inpatient stays, some surgeries, specialty services, DME, and certain high-cost procedures regardless of plan.