Understand the insurance benefits and coverage in your specific policy:

This may include Medicare, Medicare Advantage, or a commercial insurance plan you purchase on your own, through your employer, or through the marketplace. Knowing what your plan covers can help you avoid unexpected costs or delays.

If you have Medicare Part A (Hospital Insurance) or Part B (Medical Insurance), talk with your doctor or healthcare provider about the services you need. You can also learn more about Original Medicare coverage.¹

Understand Your Needs:

Think about your health goals and what matters most to you. Medical professionals have years of training. Only you know your daily needs.

You know what improves your quality of life and what does not.

Build a relationship with your Medical Professionals:

Be honest with your doctor or other healthcare provider. Ask questions. Share your concerns. Your healthcare provider should explain your options in clear terms. You should feel confident in your decisions. Strong relationships build trust. Speak up about what you need. Your care team can then support you.

Your team may include more than your Primary Care Physician (PCP). It may also include specialists and other healthcare providers.

Follow Up Consistently:

Persistence matters. Check in regularly with your healthcare provider’s office.

Make sure paperwork is sent on time.
This may include prescriptions, chart notes, prior authorizations, or letters of medical necessity.

Confirm that the DME supplier received all documents.

• Ask for names, dates, and confirmation numbers.
• Keep your own record of calls and emails.
• Following up can prevent delays.

Document Everything:

Keep copies of all documents. Request files promptly. Make sure forms are complete and include signatures and correct medical codes. Keep records both before and after submission.

Verify Information:

Errors can happen. Double-check all paperwork. If something does not look right, call your healthcare provider and ask questions.

Work with your Medical Professionals:

Review your medical records with your healthcare providers. Make sure all required documentation is there. Confirm that

Know Your Goal:

Before you begin, be clear about what you are requesting and why you need it.

Confirm Medical Necessity:

Work with your healthcare provider to show that the equipment or service is medically necessary. This means it is needed for your health and supported by your provider’s medical findings.

Do Your Homework:

Learn about the equipment or service before you request it. Make sure equipment or service fits your needs and your healthcare provider’s findings. Incomplete or unsupported requests can lead to denials and delays.

Understand Prior Authorization:

Prior authorization means your healthcare provider must get approval from your insurer before certain services or equipment can be provided.2 Prior authorization is not required for all DME products. Check with your insurer. You can also ask your DME supplier to confirm whether approval is needed.

Work with Your Healthcare Provider:

Your healthcare provider must include all required information in your record. Meet with your provider and explain how the equipment or service affects your daily life. Ask your provider to include this in chart notes, letters of medical necessity, and other required paperwork.

Share Clear Information:

Create a short list or email that explains why the equipment or service is important for your health. Explain how it will improve your daily life.

Check In-Network Providers:

Most insurance plans list in-network DME suppliers on their websites. Not all providers carry every type of equipment. Review the list carefully.

Call Ahead:

Confirm that the supplier is in-network and carries the equipment you need. Some suppliers focus on certain products, such as wheelchairs. Others offer a wider range of supplies.

Understand Out-of-Network Costs:

Out-of-network suppliers can cost more. When possible, use an in-network provider to lower expenses. Some people choose an out-of-network supplier to access a specific product or specialist.