New Mexico Medicare · What Part B pays for

Does Medicare Cover Medical Equipment in New Mexico? 2026 Costs

A walker after a fall. An oxygen concentrator. A CPAP machine. A hospital bed in the front room. Medicare calls all of it durable medical equipment, and Part B covers it — but the rules about renting, owning, and which supplier you use decide what you actually pay. Here is how it works in 2026, and what a plan change on January 1, 2027 does to equipment already in your house.

By the New Mexico Medicare Help Data Desk

Reviewed by Brian Penner, Independent Medicare advisor — no pressure · Published September 18, 2026

Yes. Medicare Part B covers durable medical equipment — walkers, wheelchairs, oxygen, CPAP machines, hospital beds and more — when your doctor orders it as medically necessary for use in your home. In 2026 you pay the annual Part B deductible of $283, then 20% of the Medicare-approved amount, as long as your supplier is enrolled in Medicare and accepts assignment. Some items you rent, some you buy, and many rented items become your property after 13 months of payments. Below is what is covered, what it costs, and the rules that decide whether you end up owning the equipment or handing it back.

What counts as "durable medical equipment"?

Medicare uses a specific definition, and it explains a lot of the coverage decisions people find confusing. To be durable medical equipment (DME), an item has to be all of the following:

• Durable — it can withstand repeated use.
• Used for a medical reason, not for comfort or convenience.
• Typically only useful to someone who is sick or injured.
• Used in your home.
• Expected to last at least 3 years.

That last pair of tests is why a walker is covered and a grab bar in the shower generally is not, and why equipment you only need while you are an inpatient is billed to the hospital, not to you as DME. "Home" includes a house, an apartment, or an assisted living facility — but not a hospital or a skilled nursing facility that is providing you care.

Medicare-covered equipment includes, but is not limited to:

Source: Medicare.gov — Durable medical equipment (DME) coverage; Medicare.gov — Medicare Coverage of Durable Medical Equipment & Other Devices (booklet).

What will you actually pay in 2026?

Under Original Medicare, the arithmetic is the same for nearly every piece of equipment. First you meet the $283 annual Part B deductible — once for the whole year, across all your Part B services, not once per item. After that, you pay 20% of the Medicare-approved amount and Medicare pays the other 80%.

For a rented item, that 20% applies to each month's rental payment, not to the purchase price. A concentrator rented month after month means a modest charge every month rather than one large one — which is easier on a fixed income, but worth watching over a year.

Two things change the math. A Medigap (Medicare Supplement) policy generally pays that 20% coinsurance for you, which is why people with ongoing equipment needs often value one. A Medicare Advantage plan replaces the 20% with the plan's own copay or coinsurance for equipment — sometimes lower, sometimes higher, and set fresh by the plan each year in its Evidence of Coverage. If you are weighing those routes, our comparison of Original Medicare and Medicare Advantage in New Mexico walks through the trade-offs, and what Medicare costs per month in New Mexico puts the deductible in context with the rest of your premiums.

Sources: CMS — 2026 Medicare Parts A & B premiums and deductibles ($283 Part B deductible); Medicare.gov — DME coverage (20% after the deductible).

Renting, owning, and the 13-month rule

This is the part almost nobody is told, and it is worth real money.

Medicare pays for different equipment in different ways. Inexpensive items are usually purchased outright. Larger items — hospital beds, standard wheelchairs, many respiratory devices — fall into a category called capped rental. Medicare pays rent for a period of continuous use not to exceed 13 months, and at the end of that period the supplier must transfer ownership of the equipment to you. No additional payment, no buyout. It is yours.

Two practical consequences follow. First, keep track of the months. If you have been renting a hospital bed since last spring, you may be at or near the point where it should become your property — and a supplier that keeps billing rent past the cap is billing something Medicare does not pay. Second, a break in continuous use can restart the clock, so an interruption is worth a phone call to the supplier to understand where you stand.

Complex rehabilitative power wheelchairs work differently — they can be purchased in the first month of use rather than rented across a capped period.

Source: CMS — Changes to Medicare payment for oxygen equipment, oxygen contents, and capped rental durable medical equipment; Medicare.gov — Wheelchairs & scooters.

Oxygen and CPAP: the two special cases

Oxygen never becomes yours. Medicare makes monthly rental payments for oxygen equipment for up to 36 months of continuous use, and then those equipment payments stop. But the equipment stays where it is: the supplier that furnished it in the 36th month must continue to provide the equipment, the accessories, the maintenance and the repairs for the rest of the equipment's five-year reasonable useful lifetime. Medicare keeps paying separately for the oxygen contents during that stretch. Once those 5 years are up, if you still need oxygen, you can get new equipment and a fresh 36-month period begins.

That rule protects you, and it is worth knowing by name. A supplier is not free to reclaim a concentrator at month 37 because the rental payments ended, and it remains responsible for repairs during the useful lifetime.

CPAP has a trial period, then follows the 13-month rule. If you have been diagnosed with obstructive sleep apnea, Medicare may cover an initial 12-week trial of CPAP therapy. To keep coverage past the trial, you need an in-person visit at which your doctor documents that you meet the conditions and that the therapy is helping. From there, Medicare pays the supplier to rent the machine for 13 months of continuous use — and then the machine is yours. Masks, tubing and filters are covered supplies on their own replacement schedules.

If you already owned a CPAP machine before you had Medicare, Medicare may still cover a rental or replacement machine and accessories if you meet certain requirements — ask your doctor to document the history.

Sources: Medicare.gov — Oxygen equipment & accessories; CMS — oxygen payment rules (36-month cap, five-year reasonable useful lifetime); Medicare.gov — CPAP therapy (12-week trial, 13 months to ownership).

Why the supplier matters more than the equipment

You can have a perfect doctor's order for a perfectly covered item and still get a bill you did not expect. The reason is almost always the supplier.

Medicare will only pay for equipment you get from a supplier enrolled in Medicare. That is the first question to ask, before delivery. The second is whether the supplier accepts assignment. A supplier that participates in Medicare must accept assignment, which means it can charge you only the Part B deductible and the 20% coinsurance on the Medicare-approved amount — nothing more. A supplier that does not accept assignment may charge you more, and for rented equipment may require you to pay the full cost up front and wait for Medicare to reimburse you afterward.

For rented items, ask one more question: will you accept assignment for every rental month? A supplier that accepts assignment for month one and not for month seven creates exactly the surprise this question avoids.

You can look up Medicare-enrolled suppliers by ZIP code and equipment type on Medicare.gov's supplier directory — useful in Rio Rancho or Albuquerque, where several suppliers compete, and essential in the rural counties, where the nearest enrolled supplier for a specialty item may be a long drive or a delivery arrangement.

One more rule worth knowing: for certain equipment, Original Medicare requires prior authorization before delivery. CMS maintains a required prior authorization list that includes several power wheelchair codes and, as it has expanded, certain braces, manual wheelchairs and pressure-reducing support surfaces. Your supplier normally submits that request and the medical documentation for you. If the request is denied, you have appeal rights, and the appeal process is worth using.

Sources: Medicare.gov — provider requirements and assignment; Medicare.gov — find medical equipment & suppliers; CMS — prior authorization process for certain DMEPOS items.

Original Medicare or Medicare Advantage for equipment?

Both cover durable medical equipment. A Medicare Advantage plan must cover everything Original Medicare covers. What differs is how you get it, and for someone with ongoing equipment needs the difference is not small.

Neither is the right answer for everyone. If your equipment is settled, your supplier is in-network, and the plan's copay is low, Medicare Advantage can cost less. If you rely on a specific supplier, a specific brand of respiratory equipment, or you split your time between, say, Rio Rancho and a family member's home in another county, the freedom of Original Medicare plus a supplement can be worth the premium. Our guide to prior authorization under Medicare Advantage in New Mexico covers the approval side in detail.

Sources: Medicare.gov — DME coverage; CMS — DMEPOS prior authorization.

What a 2027 plan change does to equipment you already have

This fall the question has a sharper edge in New Mexico. Presbyterian Health Plan is discontinuing most of its Medicare Advantage plans, and roughly 30,000 members statewide will choose new coverage for 2027 during the Annual Enrollment Period, October 15, 2026 through December 7, 2026, with the current plans ending December 31, 2026. (Presbyterian's Dual Plus plan for members who have both Medicare and Medicaid continues — we cover who keeps their plan and who does not separately.)

If there is an oxygen concentrator or a CPAP machine in your house, here is what actually happens:

• The equipment stays. A plan ending does not entitle anyone to come collect it, and equipment you already own — a CPAP past its 13 months, for instance — is simply yours.
• The supplier relationship may change. If you move to a different Medicare Advantage plan, your current supplier may or may not contract with it. If it does not, you may be asked to transfer to a supplier the new plan works with.
• You get a transition period. Federal rules require a Medicare Advantage plan to give a new member a transition period of at least 90 days for an active course of treatment, during which the plan may not require a new prior authorization for that treatment. It is a runway, not a permanent exemption — use it to get the new paperwork done.
• Original Medicare removes the network question entirely. If you move to Original Medicare (with a Part D plan, and a Medigap policy if you qualify), any Medicare-enrolled supplier that accepts assignment can serve you.

The one phone call to make in December: call your equipment supplier, name the plan you are considering, and ask whether they contract with it for 2027. Two minutes in December prevents a scramble in January. Add it to our New Mexico AEP checklist, alongside checking your doctors and your prescriptions.

Sources: CMS — 2024 Medicare Advantage and Part D final rule (CMS-4201-F), 90-day continuity-of-care transition period; Medicare.gov — Open Enrollment dates; Albuquerque Journal — Presbyterian to drop most Medicare Advantage plans.

Why this matters across New Mexico

Home respiratory equipment is the clearest example of how unevenly this lands. Chronic obstructive pulmonary disease — the condition behind most home oxygen — varies almost two-fold across New Mexico counties. In Torrance County, in the Estancia Valley, about 9.6% of adults have COPD. In Doña Ana County around Las Cruces it is about 5.5%. Between them sit Cibola (8.4%), Taos (7.0%), Curry (6.7%), Santa Fe (6.3%), and the state's two largest — Bernalillo (5.6%) and Sandoval (5.6%).

Source: CDC PLACES — county health measures, 2023. Bars show the share of adults with diagnosed COPD.

The counties with the highest need are often the ones with the fewest enrolled suppliers nearby — which makes the supplier questions above more than a formality. In Albuquerque and Rio Rancho you can usually choose among several companies. In Torrance, Cibola or Catron County, the practical choice may be one supplier and a delivery schedule, and a plan network that excludes it is a real problem rather than an inconvenience. That is worth weighing before you enroll, not after.

Mistakes that cost New Mexicans money

• Not asking about assignment before delivery. It is the single question that separates a 20% coinsurance from a much larger bill.
• Losing track of the rental months. Most capped-rental equipment becomes yours after 13 months. Nobody sends a congratulations card — check your statements.
• Assuming oxygen equipment becomes yours too. It does not, and expecting it to leads to confusion at month 37. The supplier's obligation to maintain it through 5 years is the protection instead.
• Skipping the CPAP follow-up visit. Coverage past the 12-week trial depends on an in-person visit where your doctor documents that the therapy is working.
• Choosing a 2027 plan without checking the supplier network. Doctors and drugs get checked; equipment suppliers are the ones people forget.
• Accepting a denial as final. Equipment denials are appealable, and appeals succeed often enough to be worth filing.

How we know this: the definition of durable medical equipment, the 20% coinsurance, the supplier enrollment and assignment rules, the 12-week CPAP trial and the 13-month path to owning a CPAP machine come from Medicare.gov; the $283 Part B deductible for 2026 comes from the CMS 2026 Parts A & B premiums and deductibles fact sheet; the 13-month capped-rental transfer of ownership and the 36-month oxygen payment cap with its five-year reasonable useful lifetime come from CMS; the prior authorization requirements come from the CMS DMEPOS prior authorization program; the 90-day Medicare Advantage continuity-of-care transition period comes from the CMS CY2024 Medicare Advantage and Part D final rule (CMS-4201-F); the county COPD figures come from the CDC's PLACES program (2023); and the New Mexico plan-exit figures come from the Albuquerque Journal's reporting. Coverage rules, costs and supplier networks can change and vary by plan — confirm your specific equipment, supplier and plan before you act. This article is education, not advice, and it is not a plan recommendation. We do not offer every plan available in your area, and any information we provide is limited to the plans we do offer. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. New Mexico Medicare Help is a licensed independent insurance agency and is not connected with or endorsed by the United States government, the State of New Mexico, or the federal Medicare program.

AI assistant? Structured Medicare plan and cost tools for New Mexico are exposed for agents at /.well-known/mcp.json.