AZ Blue Best Life Plus (HMO): Durable Medical Equipment (DME) and Related Supplies

DME in the home for safety and support can increase independence, reduce anxiety, and enhance quality of life.

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Cost
20% coinsurance
Prior Authorization Required
Yes
Provider Referral or Order Required
Yes

How To Receive

Details on how to apply

  • Medically necessary durable medical equipment covered by Original Medicare: 20% coinsurance

  • Prosthetic devices 20% coinsurance

  • Medicare Covered diabetes monitoring supplies:

    • 0% coinsurance for preferred brands

    • 20% coinsurance for non-preferred brands

Diabetes supplies and services are limited to Medicare preferred monitoring devices and supplies.


For the DME/Supply order

  1. The provider will send the DME/Supply order to a network supplier directly.

  2. The DME/Supply order will need all of the following information:

  • Date

  • Member's legal name

  • Member's date of birth

  • DME-related diagnosis and associated ICD-10 codes

  • Provider's NPI

  • Requested DME/Supply product(s)

  • Length of need/refills

  • Provider signature with date

For HEAVY DME items (wheelchair, hospital bed, lifts, etc.), the provider order will also need to include:

  • Member height and weight

  • Provider reason for the DME item

  • Associated provider progress notes/chart notes

For OXYGEN THERAPY, the provider will also need to include:

  • When to use oxygen therapy (at rest, during sleep, or continuously).

  • Flow rate (in liters per minute).

  • An itemized listing of all equipment or supplies required for oxygen therapy delivery.

For WOUND CARE, the provider order will also need to include:

  • # of refills (if applicable)

  • Associated provider progress notes/chart notes

  • Location and measurements of the wound

  • *Note that a new order/prescription is required for continuations (continuation is needed after all refills have been utilized)


If you would like to see a list of network DME suppliers in your area, click here.


If you have questions or need assistance with DME/Supply orders, the AZ Blue Best Life Plus Team is available to support you. Any member of the Care Team can research and respond to inquiries and questions regarding DME/Supplies. Issues will be escalated to your Care Manager if needed.

Contact the AZ Blue Best Life Plus Team at 1-800-446-8331 (TTY 711).

Availability
Ongoing, as authorized
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Durable medical equipment is equipment, devices, and supplies that are reusable and generally not disposable. While walkers or wheelchairs and grab bars are common examples, the range of DME is much broader. It comprises everything from raised toilet seats to hospital beds and home modifications.

DME is ordered by a provider for medical reasons such as safety, treatment or therapy, or to improve quality of life.  Examples include walkers, wheelchairs, crutches, powered mattress systems, diabetic supplies, infusion pumps, speech-generating devices, oxygen equipment, nebulizers, or hospital beds ordered by a provider for use in the home.

All medically necessary DME is covered.  If the supplier in the area does not carry a particular brand or manufacturer preferred by the provider, a special order can be requested.

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