Necessary Medical Supplies. Medical Supplies that are used with covered DME are covered when the supply is necessary for the effective use of the item/device (e.g., oxygen tubing or mask, batteries for power wheelchairs and prosthetics, or tubing for a delivery pump). Ostomy Supplies are also covered and limited to the following: • Irrigation sleeves, bags and ostomy irrigation catheters. • Pouches, face plates and belts. • Skin barriers.
Necessary Medical Supplies. Medical Supplies that are used with covered DME are covered when the supply is necessary for the effective use of the item/device (e.g., oxygen tubing or mask, batteries for power wheelchairs and prosthetics, or tubing for a delivery pump). Ostomy supplies are supplies which are medically appropriate for care and cleaning of a temporary or permanent ostomy. Covered supplies include, but are not limited to: • Irrigation sleeves, bags and ostomy irrigation catheters. • Pouches, face plates and belts. • Pouch covers. • Skin barriers. • Gauze, adhesive, and adhesive remover. • Deodorant. • Other supplies as appropriate. Note: Benefits are not available for filters, lubricants, tape, appliance cleaners, or other items not listed above (check the member specific benefit plan document for coverage of ostomy supplies). Compression garments for treatment of lymphedema when determined to be Medically Necessary.
