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Medicare Coverage for Durable Medical Mattresses and Beds
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Medicare’s contribution to the financial support of senior citizens’ medical expenses and necessities is well-known. Medicare can assist with the payment of medically essential apparatus for patients, in addition to funds designated for doctor’s visits, hospital stays, laboratory tests, and other associated expenses.
Medicare provides its fundamental coverage through Part A and Part B. “B” covers medical expenses such as lab work and doctor’s fees, whereas “A” covers significant medical expenses such as hospital expenses. Additionally, specific equipment intended for the patient’s personal use at home is encompassed in Part B, on the condition that it satisfies the criteria for classification as Durable Medical Equipment (DME).
Medicare’s contribution to the financial support of senior citizens’ medical expenses and necessities is well-known. Medicare can assist with the payment of medically essential apparatus for patients, in addition to funds designated for doctor’s visits, hospital stays, laboratory tests, and other associated expenses.
Medicare provides its fundamental coverage through Part A and Part B. “B” covers medical expenses such as lab work and doctor’s fees, whereas “A” covers significant medical expenses such as hospital expenses. Additionally, specific equipment intended for the patient’s personal use at home is encompassed in Part B, on the condition that it satisfies the criteria for classification as Durable Medical Equipment (DME).
What Qualifies As Durable Medical Equipment (DME)
The following criteria must be satisfied for an item to be designated as DME and thereby qualify for Medicare coverage:
– It needs to be deemed a medical necessity and recommended by a physician who is a Medicare-approved practitioner.
– The product needs to be durable, meaning it should last three years or more.
– The prescription request needs to be submitted no later than six months following the patient’s in-person examination by the physician.
– Records attesting to the medical necessity must be included with the Medicare request.
– DME acquired through an approved Medicare DME provider is the only DME that Medicare will pay for.
Medical Beds That Meet The Criteria For DME
A bed must be what is commonly referred to as a “hospital bed” in order to qualify as DME. This type of cot is not intended for comfort but rather for medical purposes. These mattresses feature an adjustable design that allows for adjustments to be made to the height and angle of the head and feet. Adjustable from the floor is the height of the mattress on certain variants.
Medicare may provide coverage for a bed powered by hand cranks or handheld electric motors, contingent upon the patient’s medical condition. Medicare typically excludes entirely electric motor hospital beds from its coverage. Beds that are excessively enormous or wide may be covered for patients who are extremely obese.
Medical Mattresses That Are Covered By Medicare
In order to qualify for Medicare coverage, a medical mattress must satisfy all the requirements for DME classification. Again, the intention and design must be to provide medical care, not merely comfort. A “pressure-reducing” mattress is essentially the only form of medical mattress that Medicare will cover. These are intended to promote healing and pain relief.
The following are highly regarded pressure-relieving mattresses:
– Joerns PrevaMatt Defend Mattress for Pressure Relief
– Heavy-Duty Solace Resolution Glissando Mattress
– A 5-Zone Therapeutic Support Mattress
– ThevoRelief Mattress for Pressure Relief
Unique Factors to Consider
An authorized DME item’s cost is 80% covered by Medicare; the patient is responsible for the remaining 20% out of pocket.
Medicare Advantage is an additional Medicare insurance plan that is offered by commercial insurance providers. Compared to Part B, these insurers might offer a more generous and comprehensive coverage for DME goods.
If the patient is in a care facility or at a relative’s house, the requirement that DME be for home use can still be met.
Even a medical mattress is not eligible for coverage unless it is purchased from an approved DME supplier.
