TRICARE Durable Medical Equipment (DME) Coverage & Costs
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## Quick answer TRICARE covers Durable Medical Equipment (DME) when it is prescribed by a physician and determined to be medically necessary to treat a specific illness or injury. Covered items generally must be able to withstand repeated use, serve a medical purpose, and be appropriate for home use.
Details
### What Qualifies as DME? To be covered by TRICARE, the equipment must meet several strict criteria. It must be: * **Durable:** Can withstand repeated use. * **Medical:** Primarily used for a medical purpose rather than comfort or convenience. * **Prescribed:** Ordered by a doctor for a specific condition. * **Necessary:** Essential for the treatment of an injury or illness.
Common examples of covered DME include wheelchairs, hospital beds, CPAP machines, oxygen concentrators, and nebulizers.
### Costs and Cost-Shares (2026) Your out-of-pocket costs for DME depend on your plan and beneficiary status. TRICARE often pays for the least expensive option (rental vs. purchase).
* **Active Duty Service Members (ADSMs):** $0 out-of-pocket for all medically necessary DME. * **TRICARE Prime (Active Duty Family Members):** $0 out-of-pocket if using a network provider and primary care manager referral. * **TRICARE Select (Select Group A retirees):** Typically a 20% cost-share of the TRICARE-allowed amount after the annual deductible is met (2026 rates). * **TRICARE Select (Select Group B retirees):** Typically a 25% cost-share of the TRICARE-allowed amount (2026 rates).
### Limitations and Exclusions TRICARE generally does **not** cover: * **Exercise equipment:** Treadmills, weights, or stationary bikes. * **Comfort/Convenience items:** Luxury features on wheelchairs, air conditioners, or humidifiers. * **Home modifications:** Ramps, elevators, or widened doorways. * **Over-the-counter items:** Items that do not require a prescription.
### Pre-Authorization Requirements Most high-cost DME requires pre-authorization from your regional contractor (**Humana Military** in the East or **TriWest Healthcare Alliance** in the West). Rental vs. purchase decisions are typically made by the contractor based on the expected duration of use and total cost. If you purchase an item that TRICARE only authorized for rental, you may be responsible for the full cost.
## Who this affects * **Active Duty Service Members:** Full coverage for all medically necessary equipment. * **Active Duty Family Members:** No cost on Prime; cost-shares apply on Select. * **Retirees and their Families:** Subject to annual deductibles and percentage cost-shares. * **National Guard and Reserve:** Covered via TRICARE Reserve Select (TRS) or TAMP. * **TRICARE For Life (TFL) beneficiaries:** TRICARE typically acts as the second payer to Medicare for DME.
## Sources 1. TRICARE.mil - Durable Medical Equipment: https://www.tricare.mil/CoveredServices/IsItCovered/DurableMedicalEquipment 2. TriWest Healthcare Alliance (West Region): https://www.triwest.com 3. Humana Military (East Region): https://www.humanamilitary.com 4. TRICARE.mil - Cost Terms: https://www.tricare.mil/Costs/CostTerms