Orlando Harmon
The Department of Veterans Affairs offers a range of programs that provide coverage or financial assistance for durable medical equipment (DME). The VA's Prosthetic and Sensory Aids Service has over 70 locations for the custom fitting of medical devices and aids, and more than 600 local contracts with accredited providers to ensure all veterans have access to care. The VA covers DME rentals for the first 30 days, and TRICARE will pay for DME when a doctor has determined it is medically necessary. Medicare Part B also covers the cost of DME, while the Veteran Directed Care Program provides veterans with a care budget that can be used to purchase DME.
| Characteristics | Values |
|---|---|
| VA Health Insurance Coverage for Durable Medical Equipment | The Department of Veterans Affairs has several programs that provide coverage or financial assistance for home or durable medical equipment (DME) |
| Who is Eligible? | Veterans, their spouses, dependents, or survivors who meet certain service-connected disability requirements |
| How to Apply | Apply online, by mail, or by fax. Fill out the Application for CHAMPVA Benefits (VA Form 10-10d) and submit the required supporting documents |
| Coverage for DME Rentals | DME rentals are covered for the first 30 days. Beyond 30 days, a Request for Service Form must be submitted to the VA to ensure proper care coordination and no disruption to rental services |
| Coverage for Service Dogs | Veterans who are approved for a guide or service dog may receive service dog benefits, including veterinary care and equipment |
| Coverage for Prosthetics and Orthotics | Prosthetics and orthotics are covered under VA health insurance. The VA's Prosthetic and Sensory Aids Service has over 70 locations for the custom fabrication and fitting of medical devices and aids |
| Coverage for Medically Necessary Equipment | TRICARE and the Veteran Directed Care Program will pay for durable medical equipment when a doctor has determined that it is medically necessary. Medicare Part B also covers the cost of durable medical equipment approved by Medicare |
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What You'll Learn
Veterans can get free DME from the VA
Veterans who are receiving VA care for any condition can get free VA prosthetic appliances, equipment, and services. This includes durable medical equipment (DME) such as walkers, canes, hearing aids, or catheters. The VA's Prosthetic and Sensory Aids Service has over 70 locations for the custom fabrication and fitting of state-of-the-art medical devices and aids.
To request routine DME, prosthetics, or orthotics, complete VA Form 10-10172, Request for Services (RFS), and return it to the local VA facility community care office. Routine requests should be made within 24 hours or on the next business day after the completion of healthcare services from which the prescription was generated. If DME is needed urgently or emergently to stabilize or decrease the risk of further injury, it is covered under the authorization for the visit. DME rentals are only covered for the first 30 days, after which a Request for Service Form must be submitted to the VA in advance to ensure proper care coordination.
Veterans who are approved for a guide or service dog may also receive service dog benefits, including veterinary care and equipment. The VA has over 600 local contracts with accredited providers to ensure all veterans have access to care. For additional information, contact the prosthetic chief or representative at the nearest VA medical center or visit www.prosthetics.va.gov.
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TRICARE will pay for DME if it's deemed medically necessary
TRICARE covers durable medical equipment (DME) when deemed medically necessary and prescribed by a physician. This includes items that improve, restore, or maintain the function of a malformed, diseased, or injured body part, or can otherwise minimize or prevent the deterioration of the patient's function or condition. It also includes medically necessary accessories and attachments to a DME that are required to make it \"serviceable\" for a specific disability, such as a car lift for a wheelchair.
TRICARE may cover the cost of renting or purchasing DME to improve the quality of life for beneficiaries with special needs. DME rentals are typically only covered for the first 30 days, and a Request for Service Form must be submitted to the VA for rentals extending beyond this period. TRICARE also offers medical case management services at an extra cost for those with complex health issues.
It is important to note that DME with deluxe, luxury, or immaterial features that increase the cost of the item may not be covered. Routine periodic servicing and non-medical equipment are also generally not covered. If a DME is needed urgently to stabilize or decrease the risk of further injury, it may be covered under the authorization for the visit.
For routine DME requests, the VA Form 10-10172, Request for Services (RFS), should be completed and returned to the local VA facility community care office within 24 hours or the next business day after the completion of healthcare services from which the prescription was generated.
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Medicare Part B covers DME costs
Veterans who are approved for a guide or service dog can receive service dog benefits, including veterinary care and equipment. The VA Prosthetic and Sensory Aids Service has over 70 locations for the custom fabrication and fitting of modern medical devices and aids.
Medicare Part B covers medically necessary services and supplies that meet accepted standards of medical practice to diagnose or treat a medical condition. It also covers preventive services like exams, lab tests, and screening shots to help prevent, detect, or manage a medical problem. Part B is optional, and if you have it, you pay a premium each month. The 2025 Part-B premium is $185 (or $174.70 in 2024) per month.
Medicare Part B covers the cost of durable medical equipment (DME). DME is equipment that serves a medical purpose, can withstand repeated use, and is suitable for use at home. Examples include walkers, wheelchairs, and oxygen tanks. You can purchase or rent DME from a Medicare-approved supplier after your provider certifies you need it.
Medicare Part B also covers insulin pumps under the DME benefit. If you use an insulin pump covered by Part B, your cost for a month's supply of insulin for your pump cannot be more than $35. If you have Part B and Medicare Supplement Insurance (Medigap) that pays your Part B coinsurance, your Medigap plan should cover the $35 (or less) cost for insulin.
Medicare Part A covers room, board, and a range of services provided in a skilled nursing facility (SNF). You are covered for up to 100 days each benefit period if you qualify. To qualify for Part A coverage, you must have spent at least three consecutive days as a hospital inpatient within 30 days of admission to the SNF and need skilled nursing or therapy services.
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CHAMPVA is available for family members of permanently disabled veterans
The Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) is a VA health benefits program. CHAMPVA is available for family members of permanently disabled veterans who meet certain service-connected disability requirements. This includes the spouses, dependents, and survivors of veterans.
If you are the spouse, dependent, or survivor of a veteran with a service-connected disability, you may qualify for CHAMPVA benefits. To be eligible, you must meet certain requirements, including not being enrolled in school or permanently disabled if you are over the age of 18. If you are the stepchild of a veteran and leave their household due to divorce or remarriage, you are no longer eligible for CHAMPVA. Additionally, if you are eligible for Medicare, you must have Medicare Part A and Part B to receive or maintain CHAMPVA benefits.
CHAMPVA offers a range of benefits, including health care services, prescription medications, and dental and vision insurance. If you are enrolled in CHAMPVA, you can access prescription medications through Meds by Mail and local pharmacies. For non-urgent prescriptions, Meds by Mail delivers medications to your home at no additional cost. However, if you have other health insurance with prescription coverage, you cannot use Meds by Mail. For urgent prescriptions, you can visit a local pharmacy in the OptumRx network, where you will be required to pay 25% of the prescription cost.
Furthermore, CHAMPVA participants may be eligible for discounted private dental insurance through the VA Dental Insurance Program (VADIP), which offers reduced-cost dental coverage. While CHAMPVA does not typically cover eyeglasses or contact lenses, there may be exceptions in certain cases. To determine your eligibility for CHAMPVA and understand the specific benefits available to you, it is recommended to refer to the official Veterans Health Administration website and relevant authorities.
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DME rentals are only covered for the first 30 days
The Department of Veterans Affairs offers a range of programs that provide coverage or financial assistance for durable medical equipment (DME). The VA covers the cost of DME rentals for the first 30 days. After this initial period, the Community Care Network (CCN) will not continue to pay for DME rentals. To continue renting DME beyond 30 days, a Request for Service Form must be submitted to the VA in advance to ensure uninterrupted rental services. This form is also used to request routine DME, prosthetics, or orthotics for a veteran.
It is important to distinguish between DME and medical supplies, which are disposable. The VA provides coverage for both types of items, but the specific programs and requirements differ. For example, the Aid and Attendance benefit offers financial assistance that can be used towards the purchase of DME and supplies not otherwise provided. Additionally, TRICARE (not TRICARE for Life) covers DME when a doctor deems it medically necessary, excluding items in nursing homes or those with desirable but non-essential features. Medicare Part B also covers DME costs, with CFL assisting with the 20% co-payment that Medicare does not cover.
The VA's Prosthetic and Sensory Aids Service has over 70 locations for custom fabrication and fitting of advanced medical devices and aids. The VA also has local contracts with accredited providers to ensure all veterans have access to care. This includes coverage for service dog benefits, such as veterinary care and equipment, for veterans who are approved for a guide or service dog.
To summarize, while the VA does cover DME rentals for the first 30 days, continued coverage beyond this period requires submitting a Request for Service Form. The VA offers various programs and benefits to support veterans' access to necessary DME and medical supplies.
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Frequently asked questions
Durable medical equipment (DME) includes medical devices and aids such as prosthetics, orthotics, and sensory aids.
Yes, VA health insurance covers durable medical equipment. The Department of Veterans Affairs has several programs that provide coverage or financial assistance for DME, including TRICARE, CHAMPVA, and VD-HCBS.
To request durable medical equipment, you must complete VA Form 10-10172, Request for Services (RFS), and return it to the local VA facility community care office.
For TRICARE to cover DME, a doctor must determine that the item is medically necessary. The item must not contain features that are desirable but unnecessary, and duplicates are excluded unless they serve as a fail-safe for life support. For CHAMPVA, you must fill out an Application for CHAMPVA Benefits (VA Form 10-10d) and submit the required supporting documents.
DME rentals are only covered for the first 30 days. If the rental is required beyond this period, a Request for Service Form must be submitted to the VA in advance to ensure proper care coordination and no disruption to rental services.
