Do I have to get the DME from the supplier my doctor recommends?

 

No.  You have freedom of choice regarding suppliers at any stage in the process.  You can get DME from any supplier who is enrolled with Connecticut’s Medicaid program.  The supplier will submit the bill to DSS for payment.  If you get DME from a supplier who is not enrolled with this program, Medicaid will not pay for it.

 

How long does it take to get DME?

 

It depends on whether the DME is a standard, “off the shelf” item or something that must be custom-made or fitted specifically to your needs.  Your medical equipment supplier should give you an estimated date of delivery.

 

What are some examples of DME?

 

Examples of DME include equipment to help you move around: canes, crutches, walkers and wheelchairs.

DME also includes equipment needed to care for you at home: bed pans, heat lamps or pads, hospital beds, special toilet seats and machines that help make breathing easier.

 

What if my request for DME is denied?

 

Sometimes a request for DME is denied because there isn’t enough information to understand why you need it.  Your DME supplier will then, generally, gather more information if it is needed and send it to DSS. A request for DME may also be denied if the department determines that it is not medically necessary.

 

If your request for DME is denied, you may request a Fair Hearing to appeal the denial.  Depending on the circumstances, the Fair Hearing Officer may change the original decision.

 

What if the DME needs repair?

 

If your DME needs repair, contact your provider. Medicaid can pay for repairs. Working closely with your provider will make the repair process easier.

 

What if the DME needs to be replaced?

 

You must take a doctor’s prescription for a replacement device to a DME supplier, who will submit the necessary paperwork to the department for its review.

 

What is DME?

 

DME is equipment that:

can be used over and over again;

is ordinarily used for medical purposes; and

is generally not useful to a person who isn’t sick, injured or disabled.

 

Will Medicaid let me know whether my request for DME is approved?

 

Yes. You will be notified in writing whether a request has been approved or denied.

 

Where are you located?

 

We are located in 3243 N 38th St. McAllen, Texas, United States 78501.