You may know someone who uses a wheelchair or walker to help increase their mobility. But did you know that these items are just a  few of many that TRICARE may cover as durable medical equipment? Read below to learn more about how TRICARE covers DME. 

Q: What does TRICARE consider DME? 

A: TRICARE defines DME as an item that can withstand repeated use, serves a medical purpose, and generally isn’t useful to  someone who isn’t sick or injured. Common examples of DME include, but aren’t limited to: 

• Mobility aids, such as walkers and wheelchairs 
• Glucose monitors
• Infusion pumps 
• Breast pumps and breastfeeding supplies 

Q: When does TRICARE cover DME? 

A: TRICARE covers DME only when prescribed by a provider. The DME must: 

• Improve, restore, or maintain the function of a body part, or help prevent your condition from getting worse • Maximize your ability to function (consistent with your medical needs) 
• Provide the right level of performance and quality for your condition 

TRICARE covers breast pumps and breastfeeding supplies as DME at no cost for new and expecting parents. TRICARE also covers  DME customization or attachments, if your provider decides these are medically necessary or appropriate for your condition. For  example, TRICARE may cover a car lift for a wheelchair user. Your regional contractor will decide to rent or purchase your DME  based on the equipment’s cost and your condition. 

Q: Does TRICARE cover DME repairs, replacements, and maintenance? 

A: If you own DME that needs repairs, TRICARE may cover the repairs. TRICARE covers DME replacement in the following cases: • There’s a change to your physical condition. 

• The DME is damaged. 
• The DME no longer works and can’t be fixed. 
• The U.S. Food and Drug Administration says it no longer meets safety standards. 

If you need replacement DME, you’ll need a new prescription from your TRICARE-authorized provider. You may also need  supporting documentation. TRICARE only covers regular maintenance, such as testing or cleaning the machine, when the  manufacturer requires an authorized technician to service the DME. 

Q: How does TRICARE For Life cover DME? 

A: If you have TRICARE For Life coverage, you must follow Medicare’s rules for getting DME. This doesn’t apply if you live  overseas (not including U.S. territories). Check out Medicare.gov for more information about DME coverage, including where to find  DME equipment and suppliers. 

Q: What kind of equipment doesn’t TRICARE cover? 

A: TRICARE doesn’t cover equipment if: 

• It has deluxe, unnecessary features that increase its cost. 
• It doesn’t serve a solely medical purpose, like humidifiers or smart watches. 
• You could get the same equipment from a military hospital or clinic, if you’re enrolled at one. 
• You’re a patient in a facility that provides the equipment as part of its typical services at no extra cost. • It’s an exact duplicate of an item you already own and will only serve as a backup. 

Note: TRICARE may cover items that aren’t exact duplicates. For example, TRICARE may cover a portable oxygen machine as a  backup for a stationary oxygen machine. 

Q: What will I pay for DME under TRICARE? 

A: Copayments and cost-shares for DME vary depending on your TRICARE plan and sponsor’s status. Typically, network  providers and suppliers will cost you less out of pocket than non-network providers and suppliers. Use the TRICARE Compare Cost  Tool to check your potential DME costs.

*For more information, head over to TRICARE/DME. For more posts from DHA, check out their M:M Expert Author Page.