Durable Medical Equipment After Hospital Discharge in Illinois

Your parent is leaving the hospital and needs a hospital bed at home, a wheelchair, or oxygen equipment. The discharge planner says it's being "ordered"—but who pays, who delivers it, and what happens if it's not there when your parent arrives home?

What Qualifies as Durable Medical Equipment

Under Medicare and Illinois Medicaid, DME includes items that:

• Can withstand repeated use (not disposable)
• Serve a medical purpose
• Are primarily used in the patient's home
• Would not normally be useful to someone who isn't ill or injured

Common DME after hospital discharge:

• Hospital beds (manual or electric)
• Wheelchairs (standard manual or power)
• Walkers and rollators
• Oxygen equipment and concentrators
• CPAP/BiPAP machines
• Commode chairs and shower benches
• Nebulizers
• Patient lifts (Hoyer lifts)
• Pressure-reducing mattresses
• Continuous passive motion machines (post-surgery)

How Medicare Covers DME

Medicare Part B covers 80% of the Medicare-approved amount for DME when:

• A physician writes a prescription (Certificate of Medical Necessity)
• The equipment is medically necessary for the condition
• The supplier is enrolled in Medicare
• Prior authorization is obtained for certain items (power wheelchairs, some orthotics)

The patient pays the remaining 20% coinsurance plus any excess charges if using a non-participating supplier. Medicare supplemental insurance (Medigap) often covers the 20%.

Rental vs purchase: Medicare rents most DME (hospital beds, wheelchairs) for 13 months, then ownership transfers to the patient. During rental, Medicare handles repairs and replacements.

Competitive bidding areas: In parts of Illinois (notably the Chicago metro area), Medicare uses competitive bidding for DME. You must use a contracted supplier in these areas or Medicare won't pay—check Medicare.gov for approved suppliers by ZIP code.

How Illinois Medicaid Covers DME

For Medicaid recipients, Illinois HFS covers DME through a prior authorization process:

• The physician submits specific HFS forms depending on the equipment type
• Standard manual wheelchair: Form HFS 3701L
• Specialized seating systems: Form HFS 3701H
• Airway clearance devices: Form HFS 2305B
• HFS reviews and approves within 5-7 business days for routine items

Medicaid patients pay no out-of-pocket cost for approved equipment.

The Hospital's Role in Ordering DME

Before discharge, the hospital discharge planner should:

1. Identify all DME your parent needs at home
2. Obtain physician orders/prescriptions for each item
3. Submit prior authorization requests (if required by Medicare or Medicaid)
4. Contact a Medicare/Medicaid-enrolled DME supplier
5. Coordinate delivery timing to align with discharge

If the hospital discharge planner hasn't arranged DME by the day before discharge, escalate immediately. Ask directly: "What equipment is ordered, from which supplier, and when will it be delivered?"

What to Do When Equipment Isn't Ready

DME delivery delays are common—and dangerous. A patient sent home without a hospital bed may fall trying to get into a standard bed. Without a wheelchair, they may attempt to walk unsupported.

If equipment hasn't arrived by discharge:

Short-term solutions:

• Ask the hospital if they can delay discharge by one day for equipment delivery
• Request that the home health agency bring interim equipment (many stock basic walkers and commodes)
• Contact the DME supplier directly for rush delivery status
• Rent basic equipment (hospital bed, wheelchair) from a local medical supply store as a bridge

If the hospital won't delay discharge:

• Document that you informed the discharge planner about the missing equipment
• This strengthens any appeal—discharge without necessary DME is a safety concern
• Contact Acentra Health (888-317-0751) for Immediate Advocacy if equipment gaps make the discharge unsafe

Finding DME Suppliers in Illinois

Medicare-enrolled suppliers (required for Part B coverage):

• Search Medicare.gov/medical-equipment-suppliers by ZIP code
• In competitive bidding areas (Chicago metro), only contracted suppliers are covered
• Outside competitive bidding areas, any Medicare-enrolled supplier works

Medicaid-enrolled suppliers:

• Must be enrolled with Illinois HFS
• The hospital's DME coordinator typically has preferred vendor relationships
• The Care Coordination Unit can also recommend local suppliers

What to ask a supplier:

• Are you enrolled in Medicare/Medicaid?
• Do you serve my parent's ZIP code?
• How quickly can you deliver after receiving the order?
• Do you handle setup and training on equipment use?
• What happens if the equipment breaks—repair or replace?

Ongoing DME Needs After the Initial Discharge

Once home, your parent may need additional equipment as their condition changes. The home health nurse can assess for new needs and coordinate with the physician for orders. Common additions in the weeks after discharge:

• Grab bars and raised toilet seats (often provided by the Community Care Program)
• Bed rails (if not part of the initial hospital bed order)
• Wheelchair cushions for pressure relief
• Oxygen adjustments based on home pulse oximetry readings

The Hospital-to-Home Illinois toolkit covers the complete DME ordering process, including which HFS forms are needed for Medicaid equipment, how to handle delivery delays, and a first-72-hours equipment safety checklist.

See more Illinois guides →