TRICARE Durable Medical Equipment (DME) Coverage Guide | TRICARE.com

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## Quick answer Yes, TRICARE covers Durable Medical Equipment (DME) when it is prescribed by a physician and determined to be medically necessary. To be covered, the equipment must be able to withstand repeated use, serve a medical purpose, and generally not be useful to someone who is not ill or injured.

Details

TRICARE covers a wide range of DME, provided the item meets specific criteria established by the Defense Health Agency (DHA). DME is defined as an item that can withstand repeated use, is primarily used to serve a medical purpose, and is appropriate for use in the home.

### Covered DME Items Common examples of covered equipment include: * Wheelchairs and mobility scooters. * Hospital beds. * Oxygen concentrators and tanks. * CPAP machines (for obstructive sleep apnea). * Infusion pumps. * Breast pumps (covered for pregnant or postpartum beneficiaries).

### Costs and Copays (2026 Rates) Costs depend on your beneficiary category and the TRICARE plan you are enrolled in. * **Active Duty Service Members (ADSMs):** $0 out-of-pocket for all medically necessary DME. * **TRICARE Prime (Retirees and Families):** Generally, there is no copayment if the DME is obtained from a network provider with a referral. For 2026, point-of-service charges apply if you see a non-network provider without authorization. * **TRICARE Select (Group A):** For 2026, retirees typically pay a 20% cost-share of the TRICARE-allowed amount after meeting their annual deductible. * **TRICARE Select (Group B):** For 2026, cost-shares vary but generally range from 15% to 20% for network DME providers.

### The "Rent-to-Own" Rule TRICARE often determines whether it is more cost-effective to rent or purchase the equipment. For high-cost items like hospital beds or wheelchairs, TRICARE may pay for a monthly rental. Once the rental payments equal the purchase price, the equipment is considered "purchased" and becomes the property of the beneficiary.

### Exclusions and Limitations TRICARE generally does **not** cover: * **Convenience items:** Elevators, sauna baths, or modifications to a home (like ramps). * **Exercise equipment:** Treadmills or weights, even if recommended by a doctor. * **Deluxe features:** TRICARE only pays for the "basic" model that meets the patient's medical needs. For example, if you want a motorized wheelchair when a manual one is sufficient, you may have to pay the difference.

### Pre-Authorization Requirements Most DME requires prior authorization from your regional contractor (**Humana Military** in the East or **TriWest Healthcare Alliance** in the West). This is especially true for any item costing more than $2,000 or for specialized equipment like customized wheelchairs.

## Who this affects * **Active Duty Service Members:** Fully covered with no out-of-pocket costs. * **Active Duty Family Members:** Covered under Prime and Select; costs vary by plan. * **Retirees and their Families:** Subject to deductibles and cost-shares. * **National Guard and Reserve:** Covered via TRICARE Reserve Select (TRS). * **Survivors and Medically Retired:** Beneficiaries retain DME coverage based on their specific plan status.

## Sources * **TRICARE.mil:** Durable Medical Equipment Overview [https://www.tricare.mil/CoveredServices/IsItCovered/DME](https://www.tricare.mil/CoveredServices/IsItCovered/DME) * **Humana Military (East):** DME Authorizations [https://www.humanamilitary.com/](https://www.humanamilitary.com/) * **TriWest Healthcare Alliance (West):** Provider and Benefit Resources [https://www.triwest.com/](https://www.triwest.com/) * **TRICARE Policy Manual:** Section 6010.57-M [https://manuals.health.mil/](https://manuals.health.mil/)