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Medicare Covers Adjustable Beds Here Is what You Should Know
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There are many companies selling all types of adjustable beds. Most of these advertised beds are not going to be Medicare covered. The kind of adjustable bed that might be eligible for coverage is usually referred to as a “hospital bed”. The main purpose and design of such beds is to serve medical needs and not just comfort.
There are many companies selling all types of adjustable beds. Most of these advertised beds are not going to be Medicare covered. The kind of adjustable bed that might be eligible for coverage is usually referred to as a “hospital bed”. The main purpose and design of such beds is to serve medical needs and not just comfort.
General Medicare Coverage
Regular Medicare is comprised of Parts A and B. Enrollment in Part A is automatic at age 65 and an application is needed to enroll in Part B. It is Part B that covers certain medical expenses out of the hospital, including doctor visits, outpatient therapy and similar. Part B also covers what is called Durable Medical Equipment (DME). In certain cases, a hospital bed can be covered under Part B as a DME.
Medicare Coverage For an Adjustable (Hospital) Bed
Requirements to get Medicare coverage for a hospital bed:
– A medical doctor, who must be an approved and participating Medicare physician, must explicitly prescribe the bed for you.
– This prescription must in detail justify that such a bed is a medical necessity for you.
– Documentation of related medical conditions concerning the need for such a bed will have to be submitted as well.
– An appropriate in-person exam of the patient must be made by the prescribing physician no more than six months before the request.
Types Of Beds
A Medicare covered type of bed must be obtained through a Medicare approved and participating DME supplier. If your request is approved by Medicare, then 80% of the cost will be paid directly to the supplier by Medicare and the patient will have to pay the remaining 20%. Most of the time, the bed can be obtained as a purchase or a rental.
The following are the types of hospital beds that can be covered:
– Manual Controlled Hospital Bed: A hand crank is used to adjust the angle of the head of the bed, the foot of the bed and in some models (if medically necessary) the height of the bed off the floor.
– Semi Electric Hospital Bed: This bed has electric motors, which are controlled by a wired hand-held device, to adjust the head and foot of the bed. Any overall height adjustment (if applicable) will still be controlled by a hand crank.
– Heavy Duty/Extra Wide Hospital Bed: This is used for approved patients who also are very obese or need cumbersome equipment or cushions.
It should be noted that fully electric (head, foot and height) beds are usually not covered.
Additional Factors and Information
– Medicare Advantage Plans (Part C), available from private insurance companies, might offer broader and more liberal coverage for DMEs, including hospital beds.
– If your medical need for such a bed is short term, Medicare may only cover a rental of the bed.
– Covered DMEs usually have to be for home use, but “home” can include a long-term care facility or a relative’s home.
– If medically necessary, special mattresses, cushions, railings and similar items might also be covered.
