Medical Supplies, Equipment and Appliances Durable Medical Equipment - MEDICAID - OKLAHOMA

This policy covers durable medical equipment (DME)/home medical equipment (HME), medical supplies and appliances (MSEA) — including regular hospital bed mattresses (E0271/E0272) — when prescribed for long‑term or everyday therapeutic/home use to address functional needs related to medical conditions (e.g., individuals who require assistance with activities of daily living or who qualify for a manual/semielectric hospital bed at home). Coverage is limited to items that meet the DME definition (non‑disposable, withstand repeated use, primarily medical in purpose, appropriate for home/community use, and prescribed by a practitioner), excludes items provided by hospitals or skilled nursing facilities or those primarily for comfort/convenience, and is subject to the Plan’s determination of rental vs. purchase and repair/replacement rules.

"Replacement polycarbonate bottle for use with breast pump (HCPCS A4285)."