Do you need a wheelchair, leg brace, or other durable medical equipment (DME) to support your well-being and independence at home? You’ll be glad to know that Louisiana Medicaid may cover the cost of your equipment. Read on to learn the basics of DME, how to request DME coverage, which waivers have DME benefits, and more. Let’s get into it!
What is Durable Medical Equipment (DME)?
For those who need to know the basics, durable medical equipment (DME), in the context of LA Medicaid, refers to medical devices or supplies that meet the following criteria:
- They are durable enough to be used repeatedly over time.
- They are used mainly for medical purposes.
- They wouldn’t be useful to you if you didn’t have an illness or injury.
- They are appropriate for home use.
Here are some examples of durable medical equipment that Louisiana Medicaid may cover:
- Hospital beds
- Walkers
- Wheelchairs
- Nebulizers
- CPAP machines
Just because a piece of equipment might seem to fit the definition of DME doesn’t mean that it will automatically be covered. The following are not reimbursable through Louisiana’s DME program:
- Dentures
- Equipment that’s not clinically proven
- Electric lifts
- Rehabilitation equipment
- Routine and first aid items
- Scooters
*This is not an exhaustive list of non-covered equipment. To find out whether a certain equipment type would be considered DME, call the Medicaid hotline at 1-888-342-6207 and speak to a representative.
How Do You Get DME Coverage?
Should you need durable medical equipment, you might be wondering how you’d go about securing it. Per the Louisiana Department of Health website, you’ll need to go through your physician.
Simply ask them about how to obtain the equipment you believe you need. They will prescribe the equipment, and DME providers will arrange for a prior authorization request from LA Medicaid. You’ll then be able to get your equipment.
You may also ask your support coordinator for updates or assistance. If the DME process hits a snag, they may be able to contact relevant parties to move the process along.
Which LA Medicaid Waivers Have DME Benefits?
Generally, Louisiana Medicaid services are distributed to members based on the waiver(s) they qualify for. Here are the waivers currently offered through the Office for Citizens with Developmental Disabilities:
- Children’s Choice Waiver (CCW)
- New Opportunities Waiver (NOW)
- Residential Options Waiver (ROW)
- Supports Waiver
But you’d be surprised that when it comes to DME, it doesn’t matter which waiver you currently have or might be eligible for. The Louisiana Department of Health states that DME coverage is available to all Medicaid recipients when deemed medically necessary for their care.
So, if you are a current Medicaid beneficiary, you are eligible. However, there may be individual eligibility requirements for specific types of DME.
Get Assistance With DME Concerns
Securing durable medical equipment for yourself or a loved one can sometimes seem like an uphill battle. That’s why support coordination agencies exist – they can help you from beginning to end. From talking to your physician to monitoring the pre-authorization process to helping you resolve issues after having received your equipment, they can really make a difference.
