If you have been paying a monthly charge for a CPAP machine, an oxygen concentrator, a wheelchair, or a hospital bed, it is fair to ask when the renting stops and the equipment becomes yours. The answer matters a great deal for any bill you get, because much home medical equipment is rented rather than bought outright -- and under Medicare a lot of it converts to your property after a set period. Knowing the rule can tell you whether a rental charge is still owed at all.
Short answer: much equipment becomes yours after a capped rental
For a large share of durable medical equipment (DME), you do eventually own it. Under Medicare, most DME is a 13-month capped rental: Medicare generally pays the supplier a monthly rental for up to 13 months, and after that 13-month cap the equipment is considered yours. The supplier transfers title to you, must continue servicing and repairing it as needed, and generally cannot keep charging you rent. Oxygen equipment follows a different path (a 36-month payment cap with a 5-year service obligation), and some low-cost items are simply purchased. Commercial plans and Medicaid may set their own rules, so the exact answer depends on your plan, your equipment, and how it was billed.
How the 13-month capped rental works under Medicare
Under Medicare, most durable medical equipment falls into a category called capped rental. Medicare generally pays the supplier a monthly rental amount for the item for up to 13 months. Common examples include a manual or power wheelchair, a hospital bed, and a CPAP machine.
- During the rental months, you typically owe your patient share of each monthly rental (often around 20% coinsurance under Medicare Part B after the deductible), not the full sticker price of the machine.
- After the 13-month cap, the equipment is generally considered yours. The supplier transfers title to you.
- Once it is yours, the supplier generally must keep servicing and repairing the equipment as needed, and generally cannot keep billing you a monthly rental for it.
So if you are still being charged "monthly rental" long after 13 months of rental payments, that is worth questioning. Ask the supplier for the rental history and payment ledger so you can see exactly how many rental months have been billed and when title should have transferred.
Oxygen equipment is different (36-month cap, 5-year service)
Oxygen equipment does not follow the same 13-month capped-rental path, and this trips people up. Under Medicare, oxygen equipment generally follows a separate 36-month payment cap. After Medicare has paid for 36 months, the supplier must keep providing the equipment and servicing it for a 5-year reasonable-useful-lifetime period.
- The key distinction: with oxygen, you do not "own" the concentrator the same way you would own a wheelchair after the 13-month cap. The supplier keeps a service obligation across the 5-year period.
- Payment is capped at 36 months, so after that point you generally should not be seeing new monthly rental charges for the same equipment during the service period, though maintenance and content rules can vary -- ask your supplier and Medicare to explain what applies to your setup.
Because oxygen is treated differently from most other DME, it is worth confirming with Medicare or your plan exactly where your equipment sits in the 36-month and 5-year timeline before assuming a charge is correct.
Items that are purchased, not capped-rental
Not every piece of equipment is rented at all. Some low-cost or routinely purchased items are simply bought, so the capped-rental clock does not apply the same way.
- Inexpensive or routinely purchased items -- a cane, a walker, or a rollator, for example -- are commonly purchased rather than rented month to month.
- Supplies and accessories, such as CPAP masks, tubing, filters, and similar disposables, are typically bought as replacement items rather than rented, even when the machine itself was a capped rental.
For purchased items, ownership generally starts at purchase, and the question is whether the charge and your patient share were billed correctly -- not when title transfers.
Commercial insurance and Medicaid follow their own rules
The 13-month, 36-month, and 5-year figures above are the general Medicare rules. Private (commercial) insurance and Medicaid may follow their own rent-to-own or purchase rules, and those can differ meaningfully from Medicare's timeline.
- Some commercial plans have their own rent-to-own arrangement that converts to ownership after a set number of months; others may purchase certain items up front.
- Medicaid rules vary by state and by the specific item.
- If you bought or financed equipment on your own (self-pay or a financing plan), ownership follows the terms of that purchase or financing contract, not Medicare's capped-rental rules.
Because of this variation, always check your specific plan documents and ask your plan directly when you think a rental should have converted to ownership.
What to do if a supplier bills past the cap or tries to repossess paid-off equipment
The ownership rules only help you if you use them. If a supplier bills you for "ongoing rental" after the applicable cap, threatens to repossess equipment you have already paid off through the capped-rental period, or refuses to service equipment that is now yours, that may be improper -- but whether any particular charge is correct depends on your plan, your equipment, and how it was billed, so gather the facts first.
- Ask the supplier in writing for the full rental history and payment ledger -- how many rental months were billed, when title transferred (or should have), and what service obligation remains.
- Compare that against your Medicare or insurance statements to see whether the cap has been reached.
- If a supplier appears to be billing past the cap or wrongly demanding equipment back, you can report it to Medicare or your plan and to your state consumer-protection office; the CFPB and the FTC also take complaints, and a legal-aid office can help.
- Never stop using, return, or go without medically necessary equipment over a billing dispute. Keep using your CPAP, oxygen, or wheelchair while you sort out the paperwork.
For a fuller picture of what happens to a possibly-improper balance if it goes unpaid, see what happens if you don't pay a medical equipment bill.
How this affects what you owe
The ownership rules can change the size of a bill. A charge for rental past the cap, or a demand to pay again for equipment that already converted to your property, may not be a genuine debt at all -- which is very different from a leftover coinsurance or deductible balance that you really do owe. Verifying where your equipment sits in the rental timeline is a free-first step you should take before treating any balance as fixed.
Only the genuinely-owed, unsecured leftover -- the correct patient share after the claim was billed properly -- is a balance to work out with the supplier. For how the rental and ownership rules change what you owe and your options for the verified leftover, see can you settle a medical equipment bill. To understand how any unpaid balance is treated on your credit report, see does an unpaid medical equipment bill hurt your credit. You can also confirm coverage details through Medicare.gov.
Bottom line
For a lot of home medical equipment, renting is temporary. Under Medicare, most DME is a 13-month capped rental after which the equipment becomes yours, the supplier transfers title, and it must keep servicing it. Oxygen is the main exception, with a separate 36-month payment cap and a 5-year service obligation. Inexpensive or routinely purchased items are simply bought, and commercial plans and Medicaid may follow their own rules. Before you treat a rental charge as owed, pull the rental history and your Medicare or plan statements, confirm where you are in the timeline, and question any charge that appears to run past the cap.
This page is general information, not medical, legal, tax, or financial advice. Never stop using or return medically necessary equipment over a billing dispute. Whether a medical equipment charge is correct, whether a claim should have been covered, whether and when you own rented equipment, whether the balance is reported, and how much (if anything) is genuinely owed all depend on your plan, your equipment, your state, and how it was billed -- read your bill and your Medicare or insurance statements carefully, keep every document, and talk to your equipment supplier, your plan or Medicare, and a legal-aid office or your state consumer-protection office if something looks wrong.