Getting Wound Care on Prescription (US)

Durable Medical Equipment is a category of medical products that a licensed healthcare provider can prescribe for home use.

To qualify as DME, a product generally needs to:

• Serve a medical purpose not just comfort or convenience
• Be used in the home
• Be prescribed by a doctor
• Not be useful to someone without a medical condition

You’ve probably heard of common DME items like wheelchairs, hospital beds, and oxygen equipment. What many people don’t realise is that wound care products, including specialised dressings and garment-based retention systems like HidraWear, also fall into this category.

In most cases, yes. Here’s a quick overview by plan type.

Medicare Part B
Covers DME when your doctor certifies medical necessity. For HS wound care, this typically includes advanced dressings and retention garments. Most patients pay 20% of the Medicare-approved amount after their Part B deductible, and if you have a supplemental Medigap plan, even that 20% may be covered.

Medicaid
Coverage varies by state, but most state Medicaid programs cover medically necessary DME with little or no copay. Some states have specific wound care supply programs. Check with your state Medicaid office for details.

Commercial Insurance
Most major commercial plans, including Blue Cross Blue Shield, UnitedHealthcare, Aetna, Cigna, and Humana, include DME as a standard benefit. Your out-of-pocket cost depends on your plan’s deductible and copay structure, but many patients pay little to nothing after insurance.

HSA and FSA Cards
HidraWear is now also available for purchase using HSA (Health Savings Account) and FSA (Flexible Spending Account) cards, making it accessible even outside a formal DME prescription process.

Every plan is different, and coverage cannot be guaranteed, but the vast majority of patients with any form of health insurance have at least some DME benefit. It is always worth checking.

The process is more straightforward than most people expect.

Step 1: Talk to your doctor
Tell your doctor about your HS wounds and how you’ve been managing them. Ask specifically: “Am I a candidate for durable medical equipment for wound care?” Your physician needs to prescribe or order the DME for insurance to cover it.

Step 2: Get a prescription
Your physician documents the medical necessity, explaining to your insurance company why you need these products. The more detail your physician provides, the smoother the approval process tends to be.

Step 3: Work with a DME supplier
Your physician sends the prescription to a DME supplier, who handles insurance verification, obtains any required pre-authorisations, and ships the products directly to your home. A good DME supplier does the heavy lifting: you shouldn’t have to navigate the insurance process alone.

Step 4: Receive your HidraWear at home
Your wound care products arrive with instructions for use. Orders typically cover 90 days of product, which you can reorder monthly during that period.

Step 5: Follow up with your doctor
After 90 days, follow up with your physician to monitor progress and get a new order if needed.