Durable Medical Equipment (DME)
What is Durable Medical Equipment?
Durable medical equipment (DME) and disposable medical supplies are a Health First Colorado (Colorado's Medicaid Program) benefit that provides clients with medical equipment and/or disposable supplies when there is a medical need for the treatment or therapy of an illness or physical condition.
What items are considered DME and supplies?
DME must serve a medical purpose and be able to withstand repeated use. Some examples of equipment that are considered DME include: oxygen, wheelchairs, walkers and bathroom/bedroom safety equipment. Supplies must also serve a medical purpose, but they are not intended for repeated use. Supply items are items used in active treatment or therapy that are disposable or can be consumed. Some examples of supplies that are covered include: diabetic monitoring supplies, oral enteral formulas and supplies, and parenteral supplies.
Who is eligible?
All clients enrolled in Health First Colorado are eligible to receive this benefit. The DME/supply must be prescribed by an appropriate physician, physician’s assistant or nurse practitioner and must be medically necessary.
What does medically necessary mean?
Medically necessary, in general, means that the DME/supply has a medical purpose that is appropriate for the intended use, it is the most cost effective item available, and it provides for a safe environment. Items that are experimental or investigational, or that are intended for personal comfort or convenience for the client or caretaker are not considered medically necessary. Some items require the provider to submit a prior authorization to determine medical necessity.
How do I get DME and supplies?
Step 1: Your physician will determine the appropriate DME/supplies necessary to meet your medical needs. In some cases, your physician will refer you to a licensed practitioner who will recommend specific equipment.
Step 2: Your physician will write a prescription for the recommended DME and/or supply.
Step 3: You may submit the prescription to the DME supplier of your choice as long as they accept Health First Colorado. They will process the order for the DME/supply and obtain the prior authorization if it is needed.
Complex Rehabilitation Technology (CRT)
CRT products include medically necessary and individually configured manual and power wheelchairs, seating and positioning systems, and other adaptive equipment such as standing devices and gait trainers. This specialized equipment requires evaluation, configuration, fitting, adjustment, or programming to meet the individual’s medical needs and maximize function and independence.
Who do I contact if I need help locating a DME supplier?
Please contact the Member Contact Center.