When you need medical equipment like a wheelchair or oxygen concentrator, you’re faced with a choice that could cost you thousands. Most people assume renting is always cheaper upfront while buying saves money long-term. That assumption can cost you serious money.

The Hidden 13-Month Ownership Rule

Medicare operates under a “capped rental” system that most people never hear about. For most durable medical equipment, Medicare covers 80% of rental costs for exactly 13 months. After that thirteenth month? You automatically own the equipment whether you wanted to buy it or not.

Here’s the math nobody explains: you’re making payments toward ownership without realizing it. Medicare pays 10% of purchase price for months 1-3, then 7.5% for months 4-13. By month 13, you’ve paid the full purchase price through rental fees.

Power wheelchairs work differently. Medicare pays 15% of purchase price for the first three months, then 6% for months 4-13. Same outcome—you own it after 13 months.

When Rental Actually Saves Money

Renting works best for equipment needs under 10 months. Since rental costs typically exceed purchase prices after 6-10 months for most devices, short-term needs favor rental.

Rental provides immediate access without crushing upfront costs. Instead of paying $3,000 for a hospital bed, you pay $150-200 monthly. Insurance covers 80% of rental fees, preserving your cash flow.

There’s another overlooked advantage: rental agreements include maintenance and servicing. Complex equipment requiring specialized repairs can add hundreds in costs that rental arrangements absorb completely.

The Purchase Math That Surprises People

Buying makes sense when you need equipment beyond 10 months. Insurance typically covers 80-85% of purchase prices versus 80-100% of rental costs, but total out-of-pocket often costs less with purchase.

Consider a $2,400 wheelchair scenario. Renting costs roughly $200 monthly with 20% coinsurance—that’s $40 monthly out-of-pocket. Over 13 months, you pay $520 total. Buying immediately costs $480 out-of-pocket (20% of $2,400). You save $40 and own equipment from day one.

Purchase also provides customization options. Rental equipment comes as-is, while purchased items can be modified for specific needs.

Insurance Plan Variations Nobody Warns You About

Private insurance handles DME completely differently than Medicare. Some plans cover rentals at 100% for approved durations while only covering 80% of purchase costs. Others flip this pattern entirely.

Always verify your plan’s specific DME coverage before deciding. Use insurance comparison tools to understand coinsurance rates, deductibles, and coverage differences between rental and purchase options.

Some plans require prior authorization for expensive equipment. This process takes weeks, potentially forcing rental even when purchase would cost less overall.

Strategic Decision Framework

Start by estimating equipment duration needs. Less than 6 months? Rental usually wins. More than 12 months? Purchase typically costs less overall.

Check your specific coverage rates using Medicare’s cost calculator or your private plan’s tools. Compare actual out-of-pocket costs for both options.

Consider storage and maintenance capabilities. Purchased equipment requires space and upkeep that rental handles automatically.

Factor in potential equipment changes. Progressive conditions might require upgrades that rental accommodates more easily than purchases.

Timing Strategies That Save Hundreds

If you’re approaching Medicare eligibility, timing becomes crucial. Medicare’s 13-month rule might make waiting to rent more economical than buying with private insurance.

For current Medicare beneficiaries, starting rental in January maximizes coverage before annual deductibles reset.

Some equipment becomes yours automatically after rental periods end, even if you’d prefer returning it. Plan accordingly if storage or maintenance poses challenges.

Use DME supplier comparison sites to find providers offering the best rates for your specific situation.

Cost Traps That Drain Your Wallet

Many people rent month-to-month without realizing they’re paying toward ownership. After 10 months of rental, you might as well have purchased equipment outright.

Watch out for suppliers who aren’t Medicare-enrolled or don’t accept assignment. These providers can charge unlimited amounts above Medicare’s approved rates, sticking you with massive bills.

Equipment modifications made during rental periods might not transfer if you eventually purchase. Discuss modification policies upfront to avoid losing customizations you’ve paid for.

How do I find my insurance’s DME coverage rates?

Contact your provider directly and request specific coinsurance percentages for both rental and purchase options. Get coverage limitations in writing before making decisions.

What happens if I need equipment for exactly 13 months?

Under Medicare’s capped rental system, you’ll own equipment after month 13 automatically. Private insurance may have different ownership transfer rules.

Can I switch from rental to purchase mid-term?

Medicare allows purchase options starting in month 10. Private insurance rules vary significantly, so verify your plan’s specific switch policies.

Who covers maintenance after I own previously rented equipment?

Medicare covers reasonable maintenance and servicing after ownership transfers through rental programs. Private insurance maintenance coverage varies by plan.

What if I no longer need the equipment?

Rental agreements typically allow returns when equipment becomes medically unnecessary. Owned equipment can be sold or donated, but disposal becomes your responsibility.