Durable Medical Equipment. Durable Medical Equipment is equipment that is Medically Necessary for treatment of an illness or Accidental Injury or to prevent further deterioration. This equipment is designed for repeated use and used to treat a medical condition or illness, and includes items such as oxygen equipment, functional wheelchairs, and crutches. Durable Medical Equipment may require Prior Authorization. Only Durable Medical Equipment considered standard and/or basic as defined by nationally recognized guidelines are Covered.
Durable Medical Equipment. All benefits for Durable Medical Equipment (“DME”) includes administration, maintenance and operating costs of such equipment, if the equipment is Medically Necessary or Prior Authorized. DME includes, but is not limited to: Braces; Canes; Crutches; Intermittent positive pressure breathing machine; Hospital beds; Standard outpatient oxygen delivery systems; Traction equipment; Walkers; Wheelchairs; or Any other items that are determined to be Medically Necessary by HPN’s Managed Care Program. Replacements, repairs and adjustments to DME are limited to normal wear and tear or because of significant change in the Member’s physical condition. HPN will not be responsible for the following: Non-Medically Necessary optional attachments and modifications to DME for the comfort or convenience of the Member; Accessories for portability or travel; A second piece of equipment with or without additional accessories that is for the same or similar medical purpose as existing equipment; Home and car remodeling; and Replacement of lost or stolen equipment.
Durable Medical Equipment. Durable medical equipment (DME) and prosthetic and orthotics appliances are covered benefits as outlined in Appendix K-2, Medically necessary orthopedic inserts prescribed by a licensed physician are included as a covered benefit.
Durable Medical Equipment. As determined by the MediCard, medically prescribed items of medical equipment for repeated use, owned or rented, such as but not limited to crutches and wheelchairs which are placed in the home of a MEMBER to facilitate treatment and/or rehabilitation of illness or injury.
Durable Medical Equipment. (1) When obtained from a provider by a covered person, benefits will be payable on a usual, reasonable and customary charge basis for the purchase or rental of durable medical equipment, subject to the following:
Durable Medical Equipment. The rental (but not to exceed the total cost of purchase) or, at the option of the Plan, the purchase, adjustment, repairs and replacement of Durable Medical Equipment when prescribed by a Professional Provider and required for therapeutic use.
Durable Medical Equipment. The rental cost of: standard hospital bed, cane single tip, cane quad tip, crutches (forearm, aluminum OR forearm, wood), xxxxxx (folding, adjustable with wheels OR folding, adjustable without wheels), oxygen refill, oxygen concentrator, oxygen portable with regulator, suction pump with supplies, suction tubing (replaceable every 3 months), yank Xxxx oral suction catheter, tracheostomy care kits (for new and established tracheostomies), continuous positive airway pressure (CPAP) machine, and standard wheelchairs (to include extra-wide sizes), when prescribed by a Physician and then only at the prescribed level. If the total rental cost exceeds the purchase price, Company may, at its discretion, either rent or purchase the item for the Covered Person. This benefit is limited to one rental or purchase every three (3) years and is limited to standard equipment only, unless subject to a treatment plan.
Durable Medical Equipment when ordered by a [Member]'s Primary Care Provider and arranged through Us. Items such as walkers, wheelchairs and hearing aids are examples of durable medical equipment that are also habilitative devices.
Durable Medical Equipment. Purchase or rental of the following items when authorized in writing by the attending physician: hospital bed, crutches, cane, walker, oxygen set, respirator (a device to provide artificial respiration), standard-type wheelchair and wheelchair repairs.
Durable Medical Equipment. Except for Services covered under Durable Medical Equipment in the List of Benefits in this section.
