Yes, Medicare covers the purchase or rental of adjustable beds for home use if your doctor determines the bed to be “medically necessary.” Adjustable beds, like many other types of DME, are considered “durable medical equipment” (DME) and are covered by Medicare Part B. Find out more here.
What’s DME?
Durable medical equipment (DME) is any medical device used in connection with a patient’s health-related activities such as dressing, bathing, and toileting. DME also includes non-medical devices such as wheelchairs, mobility scooters, hearing aids, and eyeglasses.
What are Medicare Parts A and B?
Medicare is a federally financed health insurance program for those 65 and older, as well as some persons with chronic illnesses, including end-stage renal disease.
Medicare’s coverage is divided into parts, each of which covers different aspects of healthcare:
Part A of Medicare is the program section that covers inpatient stays, such as those in a hospital or skilled nursing facility. Part B of Medicare covers doctor’s visits, some medical testing, durable medical equipment (DME) (including adjustable beds), and some drugs, such as infusions and immunizations.
Who can use the Medicare-covered adjustable bed?
Adjustable beds can be used by a patient who is homebound or who is unable to safely transfer to and from a conventional bed or bedside commode.
To be eligible for a DME-qualified adjustable bed, a person’s doctor must sign a prescription declaring that the bed is medically essential. The bed is a medical necessity, according to the eligibility standards, if a person requires:
- Positioning for relieving pain or better body alignment
- Position yourself in a way that will help you breathe better
- Special attachments, such as traction devices that can’t be attached to a standard bed
You’ll pay Medicare Part B for the expense of a Medicare-covered adjustable bed. This varies by age: the initial cost is $189. You can get a Medicare-covered adjustable bed for as little as $39 for children (age 19 or younger) and $69 for those aged 20 or older.
What types of beds are covered by Medicare Part B?
In general, Medicare provides assistance to basic hospital beds, but you have a variety of options and additions if your doctor thinks they’re essential. An adjustable bed is only considered a DME by Medicare if it can be adjusted from the head or the foot, allowing a person to elevate different body areas as needed. A user should be able to lower and raise the bed’s side railings.
The following is a list of what has been included on the list of specified covered products for durable medical equipment:
- air-fluidized bed
- air pressure pad for a standard mattress
- water pressure pad for a standard mattress
- extra-wide hospital bed with side rails
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How much does the average adjustable bed cost?
If your doctor or health care provider prescribes an adjustable or hospital bed, Medicare will cover 80% of the cost. You are responsible for the remaining 20% after you have met your Part B deductible. For coverage to occur, both your doctor who prescribes the bed and the supplier must be enrolled in Medicare.
The average adjustable bed for seniors costs around $2,000, although some may cost more than $5,000. You can expect the cost of the adjustable bed to be the same no matter how large or small the bed is or how fancy or simple it looks.
Medicare doesn’t cover the cost of special-order adjustable beds or adjustable beds that don’t fit into the traditional category of adjustable beds. Medicare covers only the following category of an adjustable bed.
- Sale and lease: This type of adjustable bed may be purchased or leased from a company. Medicare pays a one-time $45 fee for each sale or lease payment.
Not-for-profit housing: A not-for-profit housing company may rent or sell adjustable beds to residents of its property. Medicare doesn’t pay for adjustable beds that are sold by a for-profit entity.
SEE ALSO – split king adjustable bed gap filler
How to purchase or rent a Medicare-covered adjustable bed?
Adjustable beds are available for purchase by Medicare recipients at any medical equipment supplier (both in-store and online) or over the phone (in some cases, the equipment may be purchased through a private physician).
When a DME is rented, Medicare pays the monthly payments, and the supplier pays for repairs. After 13 months of continuous usage, Medicare will cover the rental fees, after which the supplier must transfer ownership to the user.
To check your eligibility for this benefit, You should speak to a medical equipment provider or Medicare-approved pharmacy. You can also request an individualized statement from Medicare that summarizes your coverage and eligibility. For more information, visit Medicare.gov or your State Health Insurance Assistance Program (SHIP).
Considering buying the right adjustable bed? Look at our guide on how to choose adjustable beds that can help you make the right decision.
Conclusion
If your doctor authorizes an adjustable bed for a specific, approved necessity, Medicare Part B will reimburse a large portion of the cost.
Additional items may not be covered by Medicare Part B; instead, you may have to pay out of pocket or rely on additional insurance to cover your costs.
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