When someone comes home from a hospital stay, the hardest part is often not the medicine. It is the logistics. Who brings the walker? Who sets up the bed? Who pays for the oxygen concentrator, and for how long? The category that answers those questions is called home medical equipment, usually shortened to HME, and it overlaps almost completely with what Medicare calls durable medical equipment, or DME.

This guide walks through what the category actually includes, how a referral moves from a discharge planner to a delivery truck, what Medicare Part B pays in 2026, and the rental rules that surprise families most often. It is written for Ohio households, with a worked example from a regional health system, and it is meant to be useful whether you end up sourcing equipment from a hospital program, an independent supplier, or a mix of both.

What counts as home medical equipment

HME is not one product category. It is five or six that happen to share a delivery van. Looking at how a hospital-based program organizes its catalog is the fastest way to see the shape of it. Adena Health System's home medical equipment program in south central Ohio splits its offering into home respiratory equipment and everything else, which is a fair reflection of how the industry works.

Home respiratory equipment. Oxygen therapy, stationary oxygen concentrators and tanks, portable concentrators, CPAP and BiPAP devices with their masks and tubing, nebulizers, pulse oximetry, and suction pumps. This group is the most heavily regulated and the most likely to involve a respiratory therapist visiting the home.

Beds and bedroom safety. Hospital beds, trapeze bars, low air loss mattresses for pressure injury prevention, and overbed tables.

Mobility. Wheelchairs, transport chairs, walkers, rollators, crutches, and canes. This is the category families interact with first and replace most often. You can see the walkers, canes, and daily living aids we stock in our Mobility and Daily Living Aids collection.

Bathroom safety. Bedside commodes and shower chairs. Small equipment, outsized effect on whether someone can stay home safely.

Bracing and support. Orthotic braces prescribed after surgery or injury.

Consumable supplies. This is the quiet sixth category, and the one that never stops. Incontinence products, wound dressings, gloves, skin barrier creams, nutritional drinks, and testing supplies are used up weekly and reordered forever. They rarely arrive with the hospital bed, and families are usually left to source them separately.

How a home medical equipment referral actually works

The referral almost never starts with the patient. It starts with a discharge planner, a case manager, or a treating clinician who identifies a need before the patient leaves the building.

Using Adena's program as the example, the intake path looks like this. A referral line takes calls 24 hours a day, seven days a week, at (740) 672-5735. Intake staff begin working the referral on the call. Clinical and reimbursement specialists then verify insurance coverage, obtain precertification where the plan requires it, and assemble the paperwork. The program serves Ross, Pike, Pickaway, Vinton, Jackson, Fayette, Highland, and Hocking counties, and its home health, hospice, DME, and respiratory lines hold a three year accreditation from the Accreditation Commission for Health Care. It accepts Medicare, Medicaid, private insurance, managed care plans, and private pay.

Two things in that description are worth pulling out, because they apply no matter which supplier you use.

First, service areas are real boundaries. A hospital based HME program delivers within a defined county footprint. If you live in Montgomery, Greene, or Warren County, a program built for Ross County is not going to bring you a hospital bed. Geography drives your options more than most families expect.

Second, the supplier does the paperwork, but the physician generates it. No amount of supplier diligence replaces the order and the clinical documentation. Which brings us to the rules.

What Medicare Part B pays in 2026

Durable medical equipment is a Part B benefit, not Part A, even when the need is created by a hospital stay. The arithmetic for 2026 is straightforward.

You pay the annual Part B deductible first. For 2026 CMS set that deductible at $283, up from $257 in 2025. After the deductible is met, Medicare pays 80 percent of the approved amount for covered equipment and you are responsible for the remaining 20 percent coinsurance, unless a Medigap policy or secondary coverage picks it up. The equipment must come from a supplier enrolled in Medicare, and for many items that supplier must also accept assignment for the 20 percent figure to hold.

The order requirements that cause most denials

Since January 1, 2020, a Standard Written Order, or SWO, must reach the supplier before any DMEPOS item can be billed to Medicare. The SWO has required elements, and an incomplete one is among the most common reasons a claim is rejected.

A subset of items carries a stricter rule. CMS maintains a Required Face to Face Encounter and Written Order Prior to Delivery list. For anything on it, including power mobility devices and a set of orthoses, the treating practitioner must have conducted a documented face to face encounter with the patient within the six months before the order date, and the completed order must reach the supplier before delivery rather than merely before billing. CMS publishes the current requirements and lists here. The encounter has to relate to the condition the equipment is for, which is why a routine annual physical sometimes fails to qualify.

Rental versus purchase: the rules families do not expect

Very little expensive home medical equipment is simply bought. Medicare rents most of it on schedules that differ by category, and the schedules matter because they determine who owns the machine in your bedroom.

Capped rental items. Most DME that is not oxygen falls into a 13 month continuous rental. Medicare pays monthly for 13 months, after which title transfers and the equipment belongs to the patient.

Oxygen. Oxygen runs on its own track. Medicare pays a monthly rental fee for 36 months covering the equipment, the oxygen itself, supplies, and maintenance, with the patient paying 20 percent of each month's fee. After month 36 the rental payments stop, but the supplier keeps ownership and must continue furnishing the equipment for the remainder of its five year reasonable useful lifetime as long as the medical need continues. At the end of those five years you can elect new equipment, which starts a fresh 36 month period. Medicare.gov explains the oxygen rules in detail.

CPAP. Coverage begins with a 12 week trial after a diagnosis of obstructive sleep apnea. To continue past the trial, the patient must demonstrate adherence, defined in the governing Local Coverage Determination as using the device at least four hours per night on 70 percent of nights during any consecutive 30 day period within the first three months. Practically, that means 21 qualifying nights out of 30. A clinical re-evaluation documenting both usage and benefit must occur between the 31st and 91st day. Miss the window and continued coverage is denied, though patients who fail the initial trial can requalify after a new evaluation and, in most cases, a repeat sleep study.

Modern machines transmit usage data automatically, so adherence is not a matter of self reporting. The most common reason people fail is mask fit, which is fixable and worth raising early rather than at day 85.

Where a hospital HME program ends and a supply partner begins

Hospital based programs are built around rented capital equipment and clinical support: the concentrator, the bed, the respiratory therapist who visits. That is genuinely what they are good at, and if you need oxygen or a hospital bed, a Medicare enrolled respiratory provider in your service area is the right call.

What those programs generally do not do is keep a household stocked, month after month, with the consumables that make home care actually work. That gap is where ABD Medical operates. We are an accredited durable medical equipment and medical supplies provider based in Dayton, Ohio, and our storefront is built around the recurring items rather than the rented machines:

• Incontinence supplies, including briefs, pull ons, pads, liners, and underpads across absorbency levels
• Adult diapers and protective underwear in a full size range
• First aid and wound care dressings and supplies
• Personal care products, including skin barriers, cleansers, and bathing supplies
• Nutritional supplies for patients on supplemental or therapeutic nutrition
• Mobility and daily living aids for walking support and everyday independence

Our supplier status and the standards we operate under are documented on our CMS Supplier Statement and Client Rights and Responsibilities pages.

Ohio specifics worth knowing

Ohio Medicaid covers durable medical equipment and supplies, and many Ohio households are dually eligible, meaning Medicaid picks up cost sharing that Medicare leaves behind. Managed care plans, which cover most Ohio Medicaid members, add their own prior authorization steps on top of the federal documentation rules, so the paperwork burden is often heavier than the Medicare rules alone suggest.

Accreditation is the other signal to check. Medicare requires DMEPOS suppliers to be accredited by an approved organization, and the names you will see in Ohio include ACHC, HQAA, and the Joint Commission. Accreditation is not marketing. It is a condition of billing Medicare at all.

If you are still deciding who to work with, our guide to choosing a Medicare DME supplier near you covers the questions worth asking before you commit.

Frequently asked questions

Is home medical equipment the same thing as durable medical equipment?

In practice, yes. HME is the industry term for equipment used in the home. DME is the Medicare benefit category. They describe the same equipment from different angles, and most suppliers use the terms interchangeably.

Do I need a prescription for everything?

No. Anything billed to Medicare or another insurer requires a physician's order and supporting documentation. Items purchased out of pocket, including most incontinence supplies, wound care, and basic mobility aids, do not require a prescription.

Does Medicare cover incontinence supplies?

Original Medicare does not cover adult diapers, pull ons, or pads. Some Medicare Advantage plans include an over the counter benefit that can be applied to them, and Ohio Medicaid covers incontinence supplies for eligible members. Many of these products are also FSA and HSA eligible, which we cover in our FSA and HSA eligibility guide.

What happens to rented equipment if I switch suppliers mid rental?

It depends on the item and where you are in the rental period. Capped rental items and oxygen have specific transfer rules, and a mid period switch does not restart the clock in most circumstances. Talk to both suppliers before you make the change rather than after.

Can I get equipment delivered if I live outside a hospital program's service area?

Rented respiratory and bedroom equipment generally requires a supplier who serves your county, because someone has to deliver, set up, and maintain it. Consumable supplies are different. Those ship anywhere, which is why many families use a local provider for the machines and a mail order supplier for everything that gets used up.

Getting started

If you are preparing for a discharge, start the equipment conversation before the discharge date, not on it. Ask the case manager which items are being ordered, which supplier they are being sent to, and whether anything on the list requires a face to face encounter that has not happened yet. That single question prevents most of the delays.

For the supplies that come after the equipment, we are here. Browse the collections above, or get in touch with our team and tell us what you are managing at home.

---

This article is general information about equipment categories and insurance rules. It is not medical advice and it is not a coverage determination. Coverage depends on your specific plan, your documentation, and your clinical situation. Confirm details with your physician, your plan, and your supplier before making decisions.