Blue Cross of Idaho Logo

Express Sign-on

Thank you for registering with Blue Cross of Idaho

If you are an Individual or Family Member under age 65, please register here.

If you are an Medicare or Medicare Supplement member, please register here.

New Options for Affordable Health Insurance

MP 1.01

Durable Medical Equipment Introduction


Medical Policy

Section
Durable Medical Equipment

Original Policy Date
12/1/95

Last Review Status/Date

Issue

Return to Medical Policy Index


Disclaimer

Our medical policies are designed for informational purposes only and are not an authorization, or an explanation of benefits, or a contract.  Receipt of benefits is subject to satisfaction of all terms and conditions of the coverage.  Medical technology is constantly changing, and we reserve the right to review and update our policies periodically.


This section of the Medical Policy Reference Manual includes medical policies pertaining to Durable Medical Equipment (DME).

Durable Medical Equipment consists of items which:

  • are primarily and customarily used to serve a medical purpose;
  • are not useful to a person in the absence of illness or injury;
  • are ordered or prescribed by a physician;
  • are reusable; and
  • can stand repeated use.

Coverage for durable medical equipment may include the following:

Repair, adjustment, or replacement of parts and accessories necessary for the normal and effective functioning of the equipment.

 

Rental charges for the equipment if it can be rented for a cost less than the purchase price of the equipment.

 

Purchased equipment when the purchase of the durable medical equipment would be less expensive than the rental of the equipment or if the equipment is not available for rental.

 

Supplies and accessories necessary for the effective functioning of the durable medical equipment. (See Medical Supplies subsection 1.02)

 

Coverage for durable medical equipment is not provided for equipment that serves as a comfort or convenience item. Electrical or mechanical features which enhance basic equipment usually serve a convenience function. Determination of medical necessity should be made regarding the coverage of these features.

 

Equipment used for environmental control or to enhance the environmental setting or surroundings of an individual should not be considered durable medical equipment. Examples of these include air conditioners, air filters, portable Jacuzzi pumps, humidifiers, etc.


Search for Policies

Policy Feedback