If your doctor orders, you may be eligible for Medicare coverage on an adjustable bed. There are stipulations for coverage, and coverage may only extend to a rental or loan of an adjustable bed.
Keep reading to see how Medicare coverage works for adjustable beds.
Does Medicare cover adjustable beds?
Medicare Part B does cover adjustable beds when you meet certain conditions. Your doctor and the Durable Medical Equipment (DME) supplier must be enrolled as Medicare providers.
You’ll need a face-to-face doctor’s visit within six months of your doctor placing the order for your adjustable bed.
To qualify, you must have a condition that requires special positioning that isn’t possible in a standard bed, a detailed prescription from your doctor on why an adjustable bed is necessary, medical records that support the necessity, and a report that details the medical issues which require an adjustable bed.
If you require frequent positioning for pain, have cardiac disease, Chronic Pulmonary Obstructive Disease (COPD), spinal cord injuries, or severe arthritis, an adjustable bed may be beneficial.
Do I need a prescription for an adjustable bed?
You will need a doctor’s prescription to qualify for an adjustable bed. Discuss the prescription order with your doctor if you need additional mattresses or bed rails.
When does Medicare cover adjustable beds?
Medicare covers adjustable beds when they’re medically necessary. Your doctor will prescribe an adjustable bed and any additions; then, you’ll submit the prescription to an in-network DME provider.
The doctor and the DME supplier must both accept Medicare. Once Medicare approves the claim, you’ll get your adjustable bed.
Which adjustable beds will Medicare cover?
Medicare will cover a basic hospital bed. Your doctor must add additions to your prescription order if you need additions. Coverage limitations may apply, but at least some additions may have coverage.
Durable Medical Equipment covers quite a few things about beds and bedding items. Coverage may be available to you on the following items:
- Air-Fluidized Bed
- Fixed-height hospital bed, with or without a mattress or side rails
- Variable-height hospital bed, with or without a mattress or side rails
- Semi-electric hospital bed with head and foot adjustment, with or without a mattress or side rails
- Total electric hospital bed with a foot, head, and height adjustment, with or without a mattress or side rails
- Heavy-duty, extra-wide hospital bed with side rails and a weight capacity of 350 to 600 pounds, or greater than 600 pounds, with or without a mattress
- Hospital-grade, fully enclosed pediatric crib
- Gel or gel-like pressure mattress pad
- Lambswool sheepskin pad
- Synthetic sheepskin pad
- Air pressure pad for a standard mattress
- Water pressure pad for a standard mattress
- Dry pressure pad for a standard mattress
How much does an adjustable bed cost with Medicare?
Costs on adjustable beds can range from $500 up to $30,000 depending on several factors. The model of the bed, the supplier you choose, any additional insurance, and any options or extras can all affect the cost.
ICU beds are usually more expensive and only available for rental. When you use a supplier that accepts Medicare, you’ll pay 20% of the cost. That cost could be applied here if you haven’t met your Part B deductible for the year.
Which Medicare insurance policy will help cover the cost of an adjustable bed?
Medigap plans can cover the 20% you would otherwise be responsible for paying when getting your adjustable bed. These policies cover the out-of-pocket costs of your healthcare after Medicare pays its portion.
Extras might not have coverage under Part B, so you could pay out of pocket, or your Medigap policy could help pay for your share.
To find Medicare supplement insurance in your area, call us at the number above, and a licensed insurance agent will help you compare your plan options side by side. Or, fill out an online rate form to see your options now.
