DME-03

ΨΥΧΗΣ ΙΑΤΡΕΙΟΝ

Durable Medical Equipment

Select Sub-section

Indicates Non-Covered Service

Air Conduction Hearing Aids

Airway Clearance Devices

-Humana-

Artificial

Pancreas

Device

Systems

Automated Insulin Delivery Devices

Automatic

External Defibrillators

Blood Glucose Monitors & Supplies

Bowel Management Devices

Cervical

Traction

Devices

-Aetna-

Electric Breast Pumps

Electrical Nerve Stimulation, Transcutaneous, Percutaneous

-Anthem-

-Cigna-

Electrical Stimulation for Pain

-Aetna-

Electrostim-ulation and Electromag-netic Therapy for Treating Wounds

-FloridaBlue-

Neuromuscular Electrical Stimulation (NMES)

-FloridaBlue-

Percutaneous Electrical Nerve Stimulation (PENS)

External Continuous Insulin Infusion Pumps

-FloridaBlue-

External Infusion Pumps

(non-insulin)

High Frequency

Chest Wall

Oscillation

-FloridaBlue-

Implantable Bone Conduction & Bone-Anchored Hearing Aids

Implantable Continuous Glucose Monitors

(I-CGM)

-Medicare-

Infant Home Cardiorespiratory Monitoring

-FloridaBlue-

Infant Home Apnea

Monitors

Mechanical

In-exsufflation Devices

Nebulizers

Negative Pressure Wound Therapy Pumps

Inpatient- OutPatient

-Medicare-

Negative Pressure Wound Therapy (NPWT)

-Aetna-

-FloridaBlue-

Vacuum Assisted Wound Therapy in the Outpatient Setting

-Humana-

-Commercial-

Neuromuscular Stimulation in the Treatment of Muscle Atrophy

Oral Appliances

for Obstructive Sleep Apnea

NonInvasive Ultrasound Osteogenesis Stimulators

-FloridaBlue-

Osteogenic Stimulation/

Non-Invasive Electrical Bone Growth Stimulators (EBGS)

-FloridaBlue-

-Medicare-

Positive Pressure Ventilation

-FloridaBlue-

Prothrombin Time Self-Monitoring Devices

Respiratory Assist Devices

-Anthem-

Speech

Generating

Devices

Suction

Pump

-FloridaBlue-

Transtympanic Micropressure Applications as a Treatment of Meniere's Disease

-FloridaBlue-

Ultrasound &

Electrical Bone Growth Stimulation

-UHC-

Ambulatory Assistance Devices

Ankle-Foot/Knee-Ankle-Foot Orthosis

-Cigna-

-Anthem-

Back-Up Ventilators in the Home Setting

Home Ventilators

-Cigna-

Canes

Crutches

Bathroom & Toilet Equipment & Supplies

-Aetna-

Compression Garments for the Legs

Continuous Passive Motion (CPM) Machines

-Aetna-

-Cigna-

-Florida Blue-

Continuous Passive Motion (CPM) and Mechanical Stretching Devices

-Humana-

Non-covered

Corset Used as Hernia Support

-Cigna-

Cranial Orthosis for Craniosynostosis

& Plagiocephaly

Cryoanalgesia & Therapeutic Cold

-Aetna-

Knee Braces

-Anthem-

Prefabricated & Prophylactic Knee Braces

-Florida Blue-

-Anthem-

Foot Orthoses, Foot Care Services

Gait Trainers

-UHC-

-Cigna-

Hand Orthotic

Heating Pads

Heat Lamps

-Cigna-

-Aetna-

Hospital Beds

Accessories

Lymphedema & Venous Stasis Ulcer Treatments

-FloridaBlue-

Mechanical Stretching Devices for Joint Stiffness & Contracture

Noninvasive Home Ventilator Therapy for Respiratory Failure

-Aetna-

-FloridaBlue-

-UHC-

Orthopedic Footwear

Orthotics

-Humana-

-Anthem-

Oxygen & Oxygen Equipment

Patient

Lifts

Pediatric Gait Trainers

Pneumatic Compression Devices

-Cigna-

-FloridaBlue-

-Humana-

Prefabricated & Prophylactic Knee Braces

Pressure Reducing Support Surfaces - Group 1

-Anthem-

Pressure Reducing Support Surfaces - Group 2

Pressure Reducing Support Surfaces - Group 3

Power Operated Vehicle (POV)

Refractive Lenses

Seat Lift Mechanisms

-Anthem-

Seat Lift Mechanisms, Patient Lifts & Standing Devices

-Cigna-

Scoliosis Braces

& Casts

Spinal Orthoses: TLSO & LSO

-Anthem-

-Medicare-

Therapeutic Chairs

Standing Frames

-Aetna-

-Anthem-

Therapeutic Shoes for Persons with Diabetes

Vitrectomy Chair/Face-Down Positioning System

-Anthem-

Walkers

Wheelchairs & Wheelchair Accessories

External Breast Prostheses

Eye

Prostheses

Facial Prostheses

Lower Limb

Prostheses

-Anthem-

Microprocessor-Controlled Prosthetic for the Lower Limb

Prosthetics

-Humana-

Prosthetic Limb Vacuum Systems

Upper Limb Prostheses

-Aetna-

Enteral Nutrition

Hyperalimentation (Total Parenteral Nutrition)

-Anthem-

Intradialytic Parenteral Nutrition

Lymphedema Garments

Ostomy

Supplies

SUPPLIES TRANSCUTANEOUS ELECTRICAL NERVE STIMULATION (TENS) & NEUROMUSCULAR ELECTRICAL STIMULATION (NMES)

Functional Electrical Stimulation & Neuromuscular Electrical Stimulation

-Aetna-

Surgical Dressings

Tracheostomy Care Supplies

Tracheostomy Speaking Valve

Urological

Supplies

-Aetna-

Indicates Non-Covered Service

Home Traction Devices - Cervical & Lumbar

-Cigna-

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