We may use a few terms in this article that can be helpful to understand when selecting the best insurance plan:
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This article looks at Medicare coverage requirements. It also examines the costs and financial assistance.
For people with certain medical conditions, such as a broken hip or paraplegia, an adjustable bed can mean greater comfort and a lower risk of further injury.
Medicare covers different types of durable medical equipment (DME), which may include an adjustable bed if a person meets the criteria.
In general, doctors do not consider an adjustable bed useful or necessary for a person who is not sick or injured. According to Medicare&#;s definitions, lounge beds &#; whether they use manual or electric power &#; are not DME.
However, there are different types of adjustable beds, and Medicare does not cover them all. For Medicare to consider an adjustable bed as DME, the bed must:
Medicare considers prescribed adjustable beds, including hospital beds , as DME. Therefore, it may cover the cost as long as a doctor certifies that a person needs the bed for home use.
Part B also covers some medical testing and some medications, such as infusions or vaccinations.
Medicare divides its coverage into parts, with each part offering coverage for different aspects of healthcare.
Medicare may cover part of the cost for necessary modifications to a person&#;s adjustable bed, such as having an air-fluidized bed for reducing pressure. Other Medicare-covered adjustments may include :
The bed should also have side rails that an individual can lower or raise.
Medicare will only consider an adjustable bed as DME if it adjusts either from the head or foot, allowing a person to elevate different body parts as necessary.
Examples of conditions for which people may need an adjustable bed include:
In the prescription, the doctor must describe the person&#;s condition and diagnosis to explain why the adjustable bed is medically necessary.
According to the eligibility requirements , the bed is a medical necessity if a person needs:
For someone to be eligible for an adjustable bed that qualifies as DME, their doctor must write a prescription stating that the bed is medically necessary.
Although Medicare helps pay for adjustable beds, a person is usually still responsible for paying a portion of the costs. Various factors can also affect the costs, such as the type of bed and the rental or purchase terms.
The person must rent or buy the bed from a supplier that accepts Medicare assignment. This means the supplier agrees to the price Medicare sets for renting or purchasing the equipment.
If someone purchases or rents a bed from a supplier that does not accept Medicare, that supplier may charge more than the Medicare-approved amount, and Medicare will not cover the cost.
If a person rents the bed, Medicare covers the monthly payments, and the supplier covers the cost of repairs. Medicare will cover the rental costs for 13 months of continuous use. After this time, the supplier must transfer ownership to the user.
To find a supplier, a person can use Medicare&#;s online tool or call 1-800-MEDICARE (1-800-633-).
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Many different adjustable beds are available, with various options for purchase or rental.
Cost factors will include:
After a person&#;s doctor certifies that a bed is medically necessary and the person obtains it from a Medicare-approved supplier, they will pay 20% of the Medicare-approved amount.
If a person has not met their Medicare Part B deductible, it will apply to the purchase or rental. For , the Medicare Part B deductible is $257.
We may use a few terms in this article that can be helpful to understand when selecting the best insurance plan:
There are times when a doctor may feel it is medically necessary for a person to use a hospital bed at home. If this is the case, then Medicare will help cover the cost of this durable medical equipment (DME).
When a doctor deems it medically necessary, Medicare will cover hospital beds to use at home. Generally, Part B will cover 80% of the cost. Medigap and Medicare Advantage may pay more.
Typically people will rent DME, but sometimes they can buy the equipment. Individuals may be able to choose whether they would like to rent or buy a hospital bed.
Items are considered DME when they meet the following criteria:
Medicare provides coverage for certain types of durable medical equipment (DME), such as hospital beds, when a doctor prescribes its use.
Under Original Medicare, Part B will cover hospital beds for use at home.
It is important that both the prescribing doctor and the supplier of the hospital bed are enrolled in Medicare. A person should always check that the supplier is part of Medicare before getting any kind of DME from them.
In order for Medicare Part B to cover a hospital bed, the prescribing doctor must not only provide a prescription but other detailed paperwork as well. They must also provide detailed information on the individual&#;s medical condition and establish the need for a hospital bed. The order must include:
Medigap, or supplement insurance, may also help pay for the costs of a hospital bed.
Medicare Advantage (Part C) plans must provide the same coverage as Original Medicare. This means they will generally cover the use of hospital beds at home. A person can speak with their provider for more information.
Learn more about Medicare Part B.
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