A practical walkthrough of Part B benefits, prior authorization, and what to expect when ordering durable equipment.
What Medicare Part B actually covers
Part B covers a wide range of durable medical equipment (DME) — wheelchairs, hospital beds, oxygen, walkers, CPAP — when prescribed for use in the home. The key phrase is medically necessary: your physician must document why the equipment is essential and you must use a Medicare-approved supplier.
Prior authorization, in plain English
Some equipment requires Medicare to approve the order before it ships. This is not a denial — it's a paperwork step. A well-prepared submission (prescription, diagnosis code, supporting clinical notes) typically clears in 3–5 business days.
What you'll pay
After your Part B deductible, you generally pay 20% of the Medicare-approved amount. Supplemental (Medigap) plans often pick up that 20%. Medicare Advantage plans vary — check your plan's DME benefit and preferred-supplier list.
Common pitfalls
The two most frequent delays we see: a prescription that's missing the diagnosis code, and a supplier who isn't Medicare-enrolled. We pre-verify both before placing an order, which is why our average turnaround is days, not weeks.
- •Get the prescription, diagnosis code, and clinical notes together up front.
- •Confirm your supplier is Medicare-enrolled before ordering.
- •Plan for 3–5 business days when prior auth is required.
Talk to a real human about your situation.
Our coordinators are available 7 days a week and can usually verify insurance the same day.