Medicare Coverage, Eligibility, and Expenses for Adjustable Beds Explained
Medicare, the government-funded healthcare programme for individuals aged 65 and over, may cover the costs of adjustable beds under specific circumstances. Here's what you need to know about Medicare's coverage for adjustable beds.
To be eligible for Medicare coverage, an adjustable bed must be classified as Durable Medical Equipment (DME). This means it must be able to adjust from the head or foot, have side rails that can be lowered or raised, and have a medical purpose. Medicare Part B covers DME, including adjustable beds.
However, Medicare does not cover adjustable beds solely for convenience or comfort. The bed must be medically necessary, meaning it is required to alleviate symptoms, improve comfort, or facilitate treatment for a specific health condition. Examples of health conditions that may require an adjustable bed include chronic obstructive pulmonary disease (COPD), paraplegia, severe injuries to the legs, severe cardiac conditions, severe arthritis, hip fractures, and more.
If a doctor prescribes an adjustable bed as medically necessary, Medicare may cover the costs of hospital-type or therapeutic adjustable beds, as well as beds with adjustable head and foot sections to assist with medical conditions such as respiratory issues, edema, or severe back pain.
To receive coverage, a person must rent or buy the bed from a supplier that accepts Medicare assignment. They will pay 20% of the Medicare-approved amount for the bed, while Medicare covers the remaining 80%. If the person rents the bed, Medicare covers the monthly payments, and the supplier covers the cost of repairs.
To be eligible for an adjustable bed that qualifies as DME, a person's doctor must write a prescription stating that the bed is medically necessary. Medicare covers the rental costs for 13 months of continuous use. After this time, the supplier must transfer ownership to the user.
If a person requires financial assistance to pay for the deductible or copay relating to an adjustable bed, they can explore other sources of help, such as Medicaid, the Department of Veterans Affairs, and philanthropic organizations.
In summary, Medicare covers adjustable beds only if they are medically necessary for treatment, with a doctor's prescription, and typically covers hospital-type or therapeutic adjustable beds rather than ordinary adjustable home beds. To find a supplier, a person can use Medicare's online tool or call 1-800-MEDICARE (1-800-633-4227).
- Medicare, a government-funded healthcare program, may cover adjustable beds under specific medical circumstances.
- For Medicare to cover an adjustable bed, it must be classified as Durable Medical Equipment (DME) with the ability to adjust from the head or foot, have adjustable side rails, and have a medical purpose.
- Medicare Part B covers DME, including adjustable beds, but they are not covered solely for convenience or comfort; they must be medically necessary.
- Health conditions such as chronic obstructive pulmonary disease (COPD), paraplegia, severe injuries to the legs, severe cardiac conditions, severe arthritis, hip fractures, and more may necessitate the use of an adjustable bed.
- To receive Medicare coverage, the person must rent or buy the adjustable bed from a supplier that accepts Medicare assignment, paying 20% of the Medicare-approved amount while Medicare covers the remaining 80%.
- A doctor's prescription stating that the bed is medically necessary is required for coverage, and Medicare covers the rental costs for 13 months of continuous use.
- If financial assistance is needed for deductibles or copays related to the adjustable bed, a person can explore other sources like Medicaid, the Department of Veterans Affairs, or philanthropic organizations.
