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Durable Medical Equipment (DME)

Durable medical equipment refers to reusable devices prescribed to assist with medical conditions or mobility challenges. Examples include wheelchairs, walkers, hospital beds, oxygen systems, and CPAP machines. Health insurance plans typically reimburse a percentage of the cost up to a maximum per item or per period.

Coverage ensures patients can manage chronic conditions at home safely and comfortably, but most insurers require medical documentation or pre-approval.

Example:

If a hospital bed costs $1,000 and your plan covers 80 percent up to $800 every five years, you pay $200.

What to Watch For:

Submit a physician’s prescription and, when required, obtain pre-authorization before purchase or rental to guarantee reimbursement.

Related Terms

Dentist

A dentist is a licensed healthcare professional who diagnoses, treats, and helps prevent conditions affecting the teeth, gums, and mouth. Dentists play a key role in maintaining oral health through preventive care, restorative treatments, and patient education. Common services include cleanings, fillings, crowns, root canals, extractions, and oral examinations.

Health Insurance

Health insurance is a type of coverage that helps pay for medical and healthcare expenses not fully covered by Canada’s public health system. It protects individuals and families from the high cost of prescription drugs, medical services, and treatments that fall outside provincial or territorial government health plans. Health insurance can be obtained through an employer’s group benefits plan or purchased individually from a private insurer.

Provincial Coordination

Provincial coordination refers to the process of aligning private insurance benefits with the coverage provided by your provincial or territorial government health plan. It ensures that the public plan pays for all eligible expenses first, and your private insurance covers only the remaining costs that are not paid by the government. This coordination helps prevent duplicate payments while maximizing your overall coverage.

Laser Eye Surgery Allowance

A laser eye surgery allowance is a vision care benefit included in some health insurance plans that provides reimbursement toward the cost of corrective laser procedures such as LASIK or PRK. These procedures permanently reshape the cornea to improve vision and reduce or eliminate the need for glasses or contact lenses. Because laser eye surgery is considered elective and not medically necessary, it is not covered by provincial health insurance plans, making this allowance a valuable feature in private coverage.

Per-Visit Maximum

A per-visit maximum is the highest dollar amount your insurance plan will reimburse for a single appointment or treatment with a healthcare provider. If the provider charges more than this set amount, you are responsible for paying the difference. This type of limit is most common in extended health plans for paramedical services, such as physiotherapy, chiropractic care, massage therapy, or acupuncture.

Relevant Plans

Plans that relate to Durable Medical Equipment (DME)

Alberta Blue Cross - Blue Assured - Basic

Alberta Blue Cross - Blue Assured - Basic

Can apply at anytime, at any age.

Alberta Blue Cross - Blue Assured - Enhanced

Alberta Blue Cross - Blue Assured - Enhanced

Can apply at anytime, at any age.

Alberta Blue Cross - Blue Assured - Enhanced+

Alberta Blue Cross - Blue Assured - Enhanced+

Can apply at anytime, at any age.

Alberta Blue Cross - Blue Assured - Premium

Alberta Blue Cross - Blue Assured - Premium

Can apply at anytime, at any age.

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