Home Medical Equipment Fees Are Rising in Several States

home medical fees rising — Image Source: Pexels

For many Americans relying on life-sustaining medical gear, the arrival of 2026 has brought a quiet but significant increase in monthly expenses. As of January 1, the cost for Home Medical Equipment (HME) and Durable Medical Equipment (DME)—ranging from oxygen concentrators to power wheelchairs—has undergone a coordinated fee schedule update. While these adjustments are designed to help suppliers keep pace with inflation, the burden is falling directly on patients in the form of higher co-insurance and out-of-pocket minimums. This trend is particularly acute in states that are phasing out competitive bidding protections or adjusting their Medicaid reimbursement tiers under the newly enacted One Big Beautiful Bill (OBBB) Act.

1. The 2026 Medicare Fee Schedule Jump

The Centers for Medicare & Medicaid Services (CMS) officially implemented a 2.0% to 2.8% increase in the DMEPOS (Durable Medical Equipment, Prosthetics, Orthotics, and Supplies) fee schedule for 2026. According to HME Business, the specific increase depends on whether the patient lives in a “former competitive bidding area.” For high-demand items like CPAP devices and oxygen equipment, a 2.8% increase is being applied directly to the 2025 rates.¹ While 2.8% may seem small, it represents a compounding cost for seniors who are already facing a nearly 10% jump in their Medicare Part B premiums this year.²

2. The Impact of ACA Tax Credit Expiration

Middle-income families who purchase private insurance through the Affordable Care Act (ACA) marketplace are facing an even steeper climb. With the expiration of enhanced premium tax credits in early 2026, many families are seeing their monthly premiums rise by an average of 18%. To absorb these costs, insurers are reclassifying medical equipment into higher cost-sharing tiers. In states like Arkansas, Georgia, and Washington, some marketplace plans have shifted DME from a flat copay to a 30% coinsurance model, meaning the patient now pays a percentage of the rising manufacturer list price rather than a fixed fee.

3. Supply Chain “Inflation Adjustments” in the Private Sector

The cost to manufacture and ship medical supplies—such as urological, ostomy, and diabetic testing products—is projected to increase by 2.41% in 2026. Unlike Medicare, which caps annual increases, private-pay suppliers are passing these “supply chain surcharges” directly to consumers. In states with high logistics costs or those implementing new 2026 environmental tariffs on medical plastics, the retail price for monthly consumables has risen as much as 5% since December.

4. State-Level Medicaid “Efficiency Adjustments”

Under the federal One Big Beautiful Bill (OBBB) framework, several states have begun “re-benchmarking” their Medicaid DME programs to save on state budgets. In states like New Jersey and Ohio, new “efficiency adjustments” have resulted in lower reimbursements for providers, who are in turn adding “administrative fees” for home delivery and equipment setup. These fees are often not covered by the insurance grant, leaving low-income seniors with a “gap bill” just to have their equipment delivered to their door.

5. The Transition to Rental-Only Models

To manage the 2026 price hikes, many insurers are eliminating the “purchase option” for mid-tier equipment like hospital beds and nebulizers. Patients are being moved to perpetual rental models, where a monthly fee is charged indefinitely. While this lowers the immediate cost, the American Association for Homecare notes that by the 13th month of a rental, the patient has often paid 150% of the item’s retail value. This “subscription” approach to medical care is becoming the new standard in 2026 for any equipment costing more than $500.

Winning the Price War: Your 2026 Action Plan

The rise in HME fees doesn’t have to break your budget if you use the new transparency tools available this year. Under the 2026 Patient-Centric Ecosystem guidelines, you have the right to request a “Good Faith Estimate” for any medical equipment before the order is finalized. If your co-pay has jumped, ask your supplier for a “Refurbished Option”; in many states, insurers are now required to offer a lower-cost rental tier for sanitized, pre-owned equipment that carries the same clinical warranty as a new device.

Have you noticed a new fee or a higher co-pay on your medical supplies this month? Leave a comment below and share which state you’re in and what equipment triggered the price hike!