TRICARE Durable Medical Equipment (DME) Coverage Guide | TRICARE.com

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## Quick answer TRICARE covers Durable Medical Equipment (DME) when it is medically necessary, prescribed by a provider, and can withstand repeated use. Generally, if the item is essential for treating an injury or illness and is not considered a "luxury" or "convenience" item, TRICARE will cover the cost of a rental or purchase.

Details

### What Qualifies as DME? To be covered by TRICARE, an item must meet the Defense Health Agency (DHA) definition of Durable Medical Equipment. Specifically, it must be able to withstand repeated use, primarily serve a medical purpose, and be appropriate for use in the home. Common examples include: * Wheelchairs and hospital beds. * Oxygen concentrators and CPAP machines. * Breast pumps (standard and hospital-grade). * Walkers, canes, and crutches. * Infusion pumps.

### Coverage Rules and Pre-Authorization Coverage depends on your specific plan and your beneficiary status. * **Active Duty Service Members (ADSMs):** Always require a referral and authorization for DME. They typically have $0 out-of-pocket costs when using a network provider. * **TRICARE Prime (Non-ADSM):** Generally requires a referral/authorization for items over a certain dollar threshold (often $2,000) or for specific high-tech equipment. * **TRICARE Select:** Does not usually require pre-authorization unless the item is specifically listed on the regional contractor’s "prior authorization required" list.

### 2026 Costs and Copays Costs for DME are subject to your annual deductible and your plan’s cost-share percentage. * **Active Duty Families (Prime):** $0 copay for DME from network providers. * **Retirees (Select/Prime):** Often subject to a 20% cost-share of the TRICARE-allowed amount (2026 rates). If using a non-network provider, these costs can be significantly higher. * **Point of Service (POS):** If Prime beneficiaries see a non-network provider for DME without a referral, they may be charged the POS deductible and a 50% cost-share.

### Accessories and Repairs TRICARE also covers the repair or replacement of medically necessary DME. However, it will not cover equipment damaged by "wrongful use" or "malice." Consumable medical supplies used with the equipment (like CPAP filters or glucose test strips) are covered under separate benefit rules.

### Regional Management The DME benefit is managed by the regional contractors. As of 2026: * **East Region:** Managed by **Humana Military**. * **West Region:** Managed by **TriWest Healthcare Alliance** (under the T-5 contract).

## Who this affects * **Active Duty Service Members:** Full coverage with prior authorization. * **Active Duty Family Members:** Covered under Prime and Select plans. * **Retirees and their Families:** Subject to cost-shares and deductibles based on Group A or B status. * **National Guard and Reserve:** Covered via TRICARE Reserve Select (TRS). * **Survivors and Medically Retired:** Eligible for DME coverage under standard retiree rules.

## Sources * **TRICARE.mil:** Durable Medical Equipment (https://www.tricare.mil/CoveredServices/IsItCovered/DME) * **Humana Military (East):** DME Guidelines (https://www.humanamilitary.com) * **TriWest Healthcare Alliance (West):** DME Authorization (https://www.triwest.com) * **Defense Health Agency:** TRICARE Policy Manual (https://manuals.health.mil)