The Department of Veterans Affairs has many different programs that provide coverage or financial assistance for home or durable medical equipment (DME). Each of the following programs provides different benefits.
TRICARE for Life
TRICARE for Life (TFL) is supplemental health insurance for elderly and retired members of all seven of the uniformed services and their families. TFL serves as a secondary payer to Medicare. In other words, individuals are required to have Medicare Part A and Part B. Medicare Part B covers most durable medical equipment when medically necessary. But they typically require enrollees to pay 20% of the cost. TFL works to cover Medicare co-payments. Thus, TRICARE for Life will pay for the remaining 20% of the cost of durable medical equipment that Medicare does not cover. Having said that, it is strongly suggested that one confirm with TRICARE for Life that they will cover the 20% for any DME item prior to purchase.
TRICARE
TRICARE (as opposed to TRICARE for Life) will pay for durable medical equipment when a doctor has determined the item is medically necessary. However, there are certain exceptions. For individuals who live in nursing homes, typically the facility will provide the DME as part of their coverage (and therefore TRICARE will not). Items considered to contain features that may be desirable but are not necessary are excluded. For example, a walker with rollers and a handbrake might be excluded while a standard walker might be covered. Duplicate items are excluded as well, unless they serve as a fail-safe for life support.
SAH, SHA and HISA Grants
These grants are intended more for home modifications than for durable medical equipment. However, there is not always a clear distinction between the two. Improvements made to a bathroom, for example, often blur the lines between what is medical equipment and what is a home modification. Are the grab bars that are installed in a shower considered to be medical equipment or part of the home modification? Read more about the
SAH, SHA and HISA Grants.
Veterans’ Pension Benefits
Pension benefits can provide cash assistance to veterans who meet the income limits. For example, the
Aid and Attendance benefit provides a monthly payment added to the veteran’s monthly pension payment. This financial assistance can be used toward any purpose the veteran chooses, including the purchase of durable medical equipment and supplies not otherwise provided.