If you have trouble getting out of a chair or sitting down in a chair, you probably questioned whether Medicare will cover a lift chair. You may need this device for safety or comfort reasons to help get from sitting to standing and vice versa.
In this context, we’ll review Medicare coverage for lift chairs, seat lift mechanisms, and how you can qualify for coverage. We’ll also discuss Insurance options that could lower your costs.
Will Medicare pay for lift chairs?
Medicare does not cover the chair portion of the chair lift. Instead, Medicare will cover the seat lift mechanism. The chair itself is not considered medically necessary; the mechanical portion of the seat lift needs to be deemed medically necessary by your doctor.
Your doctor will need to indicate your specific health reasons for requiring the lift chair mechanism
Does Medicare cover the seat lift mechanism?
If your doctor and the Durable Medical Equipment supplier are enrolled in Medicare, you’ll have coverage for the medical equipment’s motorized mechanism. You can expect Medicare to cover 80% of the cost after the Part B deductible is met.
You may need to meet a few requirements to qualify for a seat lift mechanism.
What forms are necessary to prove medical necessity for a seat lift mechanism?
You’ll need a certification of medical necessity for a seat lift mechanism. A primary care physician will provide you with a prescription for the lift chair. You or your doctor must complete and submit form CMS-849 to CMS.
How do I qualify for Medicare to cover my lift chair mechanism?
There are several reasons you may qualify for the mechanism.
You could qualify if you:
- Can’t stand on your own from a regular chair
- Without the chair, you’re confined to a bed
- Could operate the lift chair on your own
- Walk independently (or with a walker)
- Suffer from severe arthritis of the hip or knee
Medicare won’t cover a lift chair mechanism for those in a skilled nursing facility, nursing home, or hospice. If you’re in a wheelchair, Medicare will unlikely cover the lift chair mechanism.
How much does a lift chair cost with Medicare?
Medicare covers 80% of the cost of the motorized seat lift device. You’ll be responsible for paying the 20% remaining amount, possibly the Part B deductible, and the cost of the chair itself. The total amount you pay can vary depending on the chair you get, your insurance, and more.
On average, people pay over $300 for the lifting mechanism of the chair, even with Medicare insurance. Having a Medigap plan can be beneficial since many plans cover the 20% coinsurance you otherwise pay.
FAQs
Will Medicare pay for a wheelchair and a lift chair?
As long as a doctor prescribes both, these will be medically necessary. This means that Medicare care of the wheelchair and the lift mechanism — not the chair— of a lift chair.
Does Medicare pay for a sleep chair?
Coverage is available for the lift mechanism for the lift chair “sleep chair”. You’ll cover the cost of the chair itself.
Will Medicare pay for lift chair recliners?
Extra features such as a reclining device will be costs you’re fully responsible for covering. Medicare doesn’t cover the reclining device.
Will Medicare cover Lazy Boy lift chairs?
Medicare will only cover the lift mechanism. You pay the cost of the chair whether you choose to go with a Lazy Boy or another brand.
Do Medicare Advantage plans cover lift chairs?
Part C plans might pay for a lift chair. Talk to your Medicare Advantage provider to confirm your coverage and eligibility.
Can Medigap help cover the cost of the lift chair mechanism?
Medigap insurance will cover the 20% Medicare leaves you to pay on the seat lift mechanism. Since Medicare doesn’t cover the chair itself, neither does Medigap; but the money you save on the seat mechanism can go towards the cost of the chair.
Contact us today to learn more about how Medigap can save you money. Or choose to discover your rates online by filling out a quick online rate form.
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