DME Rental Guidelines – Deseret Secure to Deseret Alliance

When a member changes from being covered by a Medicare Advantage plan (Deseret Secure) to a Medicare Supplement plan (Deseret Alliance), Medicare has specific requirements that must be met before they’ll pay benefits for rented durable medical equipment (DME). Effective January 2013, all DME claims, including rental items must be submitted to Medicare first.

Medicare’s coverage criteria and billing guidelines may include the following requirements for rented DME items:
  • The provider of the rented equipment must have a signed physician’s order on file. Also, they must ensure they have the necessary documentation on file to warrant the member’s continued use of the equipment. In some cases, it may be necessary for the physician to provide the DME provider with additional documentation, including test results and/or a certificate of medical necessity.
  • New or “like new” equipment must be provided to the member.
  • The rental period will start over again.
  • Any amount the member has paid toward the rental period before January 1, 2013, will not be applied to the new rental contract.

What Does This Mean for Members?

  • They may need to meet with their physician so the medical documentation required by Medicare can be provided to the DME provider.
  • They will be contacted by their DME provider to return the equipment currently in their possession.
  • They will be given new or “like new” equipment.
  • The rental period will start over again.
  • Any amount previously paid toward the DME rental before January 1, 2013, will not be applied to the new DME rental.