Paying for Home Hospital Beds: Medicare's Policy & ...

22 Jul.,2024

 

Paying for Home Hospital Beds: Medicare's Policy & ...

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Page Reviewed / Updated &#; January 20,

Joshua Iversen, President, Syzygy Financial LLC

Expert Reviewed By:

Medicare&#;s Policy on Home Hospital Beds

Basic home hospital beds may be paid for, in part, by Medicare Part B. Anyone who has Medicare Part B, and has a medical need for a hospital bed in their home, is able to get partial coverage under Medicare&#;s Durable Medical Equipment (DME) policy. DME is defined as medical equipment that can be reused, and a hospital bed falls under this policy. A Medicare enrolled doctor must deem the hospital bed necessary and prescribe it for use in an individual&#;s home.

Medicare will pick up 80% of the amount that is Medicare approved for the purchase of a hospital bed for home use. The individual must cover the remaining 20%. This can be paid out-of-pocket or with help from supplemental insurance, such as Medigap. One must also have met their Medicare Part B deductible, which as of is $185. Medicare will also help to cover the cost of some bed accessories, which may include trapeze bars, mattress covers that are intended to avoid bedsores, and bedside rails.

Rather than buy a home hospital bed straight out, one can also rent a hospital bed and still receive financial assistance from Medicare. With current Medicare regulations, after 13 months of renting, the individual owns the bed.

It&#;s important to note, Medicare will not cover the cost of full electric beds. However, one can pay the difference out-of-pocket between a manual-lift bed and a fully electric one. In addition, Medicare only covers a basic bed, meaning a shape very similar to a twin bed, but not identical.

In order for Medicare to pick up part of the bill, an individual must get the hospital bed from a Medicare approved supplier. If the hospital bed is purchased from a supplier that is not approved, Medicare won&#;t cover any of the cost of the hospital bed. Participating suppliers have Medicare supplier numbers. To find participating suppliers, click here or call 1-800-633-. 

Medicare Advantage Plans, such as a PPO or HMO, may also help to cover the cost of hospital beds. Since plans vary, one will need to call their provider and ask about their specific plan. It is very likely their policies will be the same as Medicare&#;s policy.

Financial Assistance & Payment Options

Medicaid

Since Medicaid is a joint federal and state program, with each state running the program as they see fit within the guidelines set forth by the federal government, rules and regulations about durable medical equipment (DME) such as home hospital beds, is not consistent across the states. That being said, each state has a Medicaid State Plan and most states also have Home and Community Based Services (HCBS) Medicaid Waivers. Both State Plans and Waivers provide assistance to help the elderly avoid nursing home placement. Therefore, Medicaid very often will cover the cost of DME, which includes home hospital beds. As with Medicare, the bed must be deemed necessary by a physician. Learn more about Medicaid and their stance on DME here. 

State Funded, Non-Medicaid Programs

Some states offer non-Medicaid assistance in obtaining durable medical equipment and hospital beds for home use for aging or low income residents. However, it&#;s important to note that these programs vary widely across the board. Click here to learn more about these programs and to see if one is available in your state.

Veterans Options

The Department of Veterans Affairs (VA) offers medical benefits for veterans that also include covering DME, such as home hospital beds. However, once again, a doctor must deem the bed medically necessary.

TRICARE for Life (TFL), a supplemental medical insurance for retired veterans, helps to cover the costs for those enrolled in Medicare that are not covered by Medicare. This holds true for DME, as TFL will pick up the 20% copayment that Medicare requires when purchasing DME. CHAMPVA for Life (CFL) offers the same benefit. But it is meant for spouses at least 65 years of age of vets who have been permanently disabled or killed in service. TRICARE, also for retired vets, also covers hospital beds (both rented and purchased), given they have been prescribed by a doctor.

There are other avenues in which a veteran can get a home hospital bed should a family feel one is required, but is not able to get a prescription. The Veteran-Directed Home and Community Based Services Program (VD-HCBS) allows participants control over what care and services meet their needs. This program should give veterans the flexibility to purchase a hospital bed even if they are unable to have one officially prescribed.

Another option is the Aid & Attendance (A&A) Program. This is a pension program for veterans who need help with their activities of daily living. Their care requirements do not need to be related to their military service. Under A&A, monies can be allocated as the beneficiary sees fit.

In addition, many states also have programs specifically for veterans. For instance, Project MEND is for residents of Texas and provides refurbished home hospital beds and mattresses to veterans and their spouses.

Tax Deductions

One may make a deduction from their federal income taxes in the event they buy a needed home hospital bed for themselves, their spouse or other dependent. It&#;s important to note that deductions for durable medical equipment can only be made in the year that they were purchased. The following examples presume the tax filer has no other medical expenses for the year.

The tax filer can deduct the cost of the bed that is over 10% of their adjusted gross income. If part of the bed was covered by insurance, the tax filer would only be able to deduct the part that was paid out-of-pocket.

Example: Carol&#;s adjusted gross income is $20,000. 10% of $20,000 is $2,000. She purchased a hospital bed for $3,000 out-of-pocket. Therefore, she can deduct $1,000 from her federal taxes.

Example: John has an adjusted gross income in the amount of $15,000. Medicare picked up $2,400 of a $3,000 bed, leaving John $600 to pay (the 20% co-payment). 10% of $15,000 is $1,500. Therefore, since the portion of the hospital bed John has to pay is not over 10% of his adjusted gross income, he cannot deduct this amount from his federal taxes.

Non-Profits & Charities

Depending on the area in which one resides, there may be non-profits and charitable organizations that give away or loan home hospital beds. For instance, the Muscular Dystrophy Association has an equipment loan program. It includes home hospital beds for those who have neuromuscular diseases, such as ALS. To learn more, click here. 

For more information on non-profit organizations that provide DME, click here. 

Home Hospital Bed Costs

The cost of a home hospital bed ranges from $500 to $10,000. The variance is largely due to features and size.

Feature Impacting Price

Electric vs. Manual
Manual Hospital Beds &#; Hospital beds that are manual are the most basic hospital beds and are adjusted via a hand crank. This crank is either attached to the head or the foot of the bed, depending on the model. This type of bed is the most affordable option, which generally starts at about $500.

Semi-Electric Hospital Beds &#; Semi-electric beds offer more convenience than do manual beds, making it much easier for one to move the position of the bed. With this type of bed, one is able to move the head and foot of the bed electronically, but still has to manually adjust the height of the bed via a crank. The price of a semi-electric bed generally starts at approximately $1,000.

Full-Electric Hospital Beds &#; Full-electric beds offer the ultimate in convenience since all movements / adjustments are made electronically. However, this type of hospital bed is the priciest, starting at around $2,000.

Bed Dimensions 
The length of a standard hospital bed from the top of the bed to the bottom of the bed is 38&#; width by 84&#; length, with the sleep surface being 36&#; width by 80&#; long. However, there are extension kits to extend the length of some hospital beds by 4&#;, which is ideal for persons that are taller than 6&#;. There are also full size hospital beds, which are 54&#; wide by 80&#; long, queen size beds that are 60&#; wide by 80&#; long, and king size beds that are 76&#; wide by 80&#; long. In addition, there are also bariatric beds that come in a larger width of 48&#;. Of course, the larger one goes in size, the more the bed will cost.

Weight Bearing
Most home hospital beds can accommodate weight up to 450 pounds. For individuals who weigh more than this, a bariatric bed is required, which can hold up to 1,000 pounds. Bariatric beds are generally full-electric beds. In general, bariatric beds can cost as much as three times more than standard hospital beds. Bariatric beds also require specific sheets and mattress pads.

Bed Sheets 
Home hospital beds require sheets that are specifically made for this type of bed. This is because a typical hospital bed is the size of a twin bed in width, but is longer in length. One should expect to pay approximately $50 for a set of sheets for a standard home hospital bed.

Mattress Pads 
Home hospital beds also require mattress pads that are specifically made for home hospital beds. A variety of different types of mattresses are available for purchase, including air, gel, and foam. Also, some serve specific purposes, such as adding comfort and helping to prevent sores from body pressure. One can find basic mattress pads starting at approximately $100.

Trapeze Bars 
These bars are used to assist individuals in switching positions, whether it be repositioning to get more comfortable or offering assistance in getting in and out of bed. Bars add $100 &#; $200 in cost.

Rails 
Both manual and electronic rails are available for purchase. One should expect to pay an additional $75 &#; $400.

IV Poles 
For those who require an IV pole, there are both IV poles that attach to hospital beds and freestanding IV poles. One should expect to pay approximately $50.

Others
Other add-ons for home hospital beds include bed trays, table trays, bedpans, call cords, and bed rail pads.

Purchasing Used Home Hospital Beds

Used hospital beds are available and can save one a significant amount of money. In fact, one can purchase a used hospital bed starting at approximately $300. While one can purchase used hospital beds from websites such as Ebay and Craigslist from private owners, these hospital beds generally will not come with any sort of warranty. Many dealers sell refurbished beds, which typically come with a 3-month to 1-year warranty. Make note, used bariatric beds are more difficult to find than standard home hospital beds.

Renting Home Hospital Beds

Renting a home hospital bed (manual, semi-electric, and full-electric) is a great option for those who will only need it for a limited period of time. This is a much more cost efficient option for short-term use. On average, it costs one $200 &#; $500 / month to rent a home hospital bed. One can also find mattresses for rent. Some companies that rent home hospital beds may charge an initial fee for set-up. If this is the case, one should expect to pay an additional $50 to $100.

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Manufacturers

To assist in one&#;s search for home hospital beds, below is a list of reputable manufacturers.

  • Drive
  • DRE
  • Hill-Rom
  • Invacare
  • Medline
  • Stryker

Does Medicare Cover Hospital Beds to Use at Home?

When medically necessary, Medicare will cover hospital beds to use at home. You&#;ll need a doctor&#;s order stating that your condition requires one. Medicare Part B will pay 80% of the cost. Medigap or Medicare Advantage plans may pay more.

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Your doctor might order a hospital bed for you to use at home for many reasons, such as if you&#;re in severe pain, having trouble breathing, or experiencing swelling in your legs and feet.

Medicare will cover the hospital bed as long it&#;s medically necessary to help your condition. Your doctor will need to order the bed and show how it will help your condition.

Medicare pays for all medical equipment, including hospital beds, under Medicare Part B. Part B will pay 80% of the cost of your hospital bed.

Contact us to discuss your requirements of electric hospital beds for sale. Our experienced sales team can help you identify the options that best suit your needs.

You might be able to get more coverage if you have a Medigap or Medicare Advantage plan.

When does Medicare cover hospital beds for home use?

Hospital beds for home use are considered durable medical equipment (DME). Medicare covers DME under Part B. Your hospital bed will need to meet a few conditions in order to be covered.

Medicare will pay for your hospital bed if:

  • You have a documented medical condition that requires a home hospital bed.
  • You&#;re under the care of a doctor for your condition and being seen at least once every 6 months.
  • Your doctor orders the bed for home use.
  • Your doctor&#;s order includes your condition and why a hospital bed will help you.
  • Your doctor participates in Medicare.
  • The equipment provider participates in Medicare.

Medicare can provide coverage for you to either rent or buy a bed.

Whether you rent or buy will depend on the type of bed your doctor orders and the policies of the company you use. You might also rent a bed at first, then purchase it if you still need it later on.

Which Medicare plans may be best for you if you know you need a hospital bed at home?

You can get coverage for hospital beds through a few different parts of Medicare.

If you use Medicare parts A and B, together called original Medicare, your coverage will be through Medicare Part B. That&#;s because Medicare Part A covers inpatient stays and care you receive in hospitals and skilled nursing facilities.

Medicare Part B covers your other healthcare needs, including:

  • doctor&#;s office visits
  • emergency room care
  • medical equipment

Part B will cover 80% of the Medicare-approved amount of your hospital bed. You&#;ll pay the remaining 20%.

You can also get coverage through a Medicare Part C plan. Part C plans, also known as Medicare Advantage plans, are offered by private companies that contract with Medicare.

They&#;re required to provide the same coverage as original Medicare. Plus, many Advantage plans go beyond the coverage of original Medicare to offer additional covered services.

So, since original Medicare covers hospital beds, all Advantage plans will also cover hospital beds. Your cost might be more or less than with original Medicare, depending on your plan.

Medicare Part D is prescription drug coverage. It won&#;t help you pay for any DME, including hospital beds.

Medigap, however, can help you pay for a hospital bed. This is Medicare supplement insurance. It covers some of the out-of-pocket costs of using original Medicare, like copayments and coinsurance amounts.

So, if you use Medicare Part B to get a hospital bed, a Medigap plan could cover the 20% coinsurance amount you&#;d normally need to pay.

What is a home hospital bed?

A hospital bed is a bed that has extra features, such as side rails, gel cushioning, or the ability to raise your head or feet. Your doctor might order a hospital bed for home use if you have:

  • arthritis, osteoporosis, or another chronic pain condition
  • heart conditions that require you to keep your head, heart, or limbs elevated
  • a condition that requires you to be repositioned for pain or pressure relief
  • a spinal cord condition or injury
  • chronic obstructive pulmonary disease that&#;s affected by your sleeping position

Which hospital beds are covered?

Medicare covers several types of hospital beds. This includes:

  • adjustable beds
  • semielectric beds with adjustable heads and feet
  • beds with side rails
  • extra-wide bariatric beds that can hold weights of 350 to 600 pounds
  • extra-wide bariatric beds that can hold weights of more than 600 pounds

Bed types are all available with a mattress or without one. Medicare also covers mattresses pads, including:

  • lambswool sheepskin pads
  • synthetic sheepskin pads
  • gel pressure pads
  • dry pressure pads
  • water pressure pads
  • air pressure pads

Hospital bed accessories

Medicare will also cover some additional features if they&#;re medically necessary. However, it won&#;t cover things that are considered convenience features.

For example, Medicare will cover accessories like trapeze pull bars that help you sit up in bed but won&#;t cover things like over-the-bed tables, which are considered a convenience and not a necessity.

Any bed you order needs to be considered medically necessary for your condition. For example, to get approved for a bariatric bed, you&#;ll need to send a medically documented recent weight.

It&#;s also important to note that while Medicare covers semielectric beds with adjustable heads and feet, it doesn&#;t cover fully electric beds.

Fully electric beds have adjustable height in addition to the adjustable head and feet. Medicare considers adjustable height a convenience feature, and won&#;t pay for it.

How much does the average hospital bed for home use cost?

The cost of a hospital bed depends on the type of bed your doctor orders.

According to Consumer Affairs, hospital bed costs start at around $500 and can often reach thousands of dollars. When you rent a hospital bed, Consumer Affairs reports, you can spend between $200 and $500 per month depending on the bed type.

Medicare can help you reduce this cost. Medicare Part B will pay 80% of your costs when you use original Medicare.

So, let&#;s say your doctor orders a bed with a cost of $1,000. In this case, Medicare would pay $800 and you&#;d pay $200. If you decide to rent a bed instead for $300 per month, Medicare would pay $240 and you&#;d pay $60.

If you have a Medigap plan, it can pick up those remaining costs, meaning you wouldn&#;t need to pay anything for your hospital bed.

Your costs with a Medicare Advantage plan will depend on the plan. Each Part C plan has its own copayment or coinsurance amounts. You can call your Advantage plan if you&#;re not sure.

The bottom line

Medicare will pay for a hospital bed for home use if it&#;s medically necessary and ordered by your doctor.

Medicare covers a variety of hospital beds to help with different conditions. Your doctor will need to specify your condition and why a hospital bed will help it.

Medicare will pay for you to buy or rent a bed. Original Medicare will pay 80% of the costs. A Medicare Advantage or Medigap plan might cover more.

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