Are Adjustable Beds Covered by Medicare?
Adjustable beds are possibly covered by Medicare Part B under the section of durable medical equipment. However, just like any medical insurance, there are requirements that must be met to qualify. First, a doctor must prescribe a hospital bed for use in the home based on medical need. Once a prescription is attained, the bed must be supplied via a Medicare supplier who accepts assignment. Even if all the requirements are met, Medicare only covers some of the expense. Patient responsibility and/or a secondary insurance company will be required to partially pay.
Renting or Buy – Adjustable Beds with Medicare
Hospital beds are adjustable beds covered by Medicare. Like other medical insurance, the deductible for Medicare must be fulfilled. From there, two payment options for acquiring the home use of a hospital bed can be considered. A patient may be given the choice to pay over a rental period or buy outright. Either way, Medicare covers 80% of the sum Medicare approves for the DME. The remaining 20% must be paid by the patient. In some circumstances, a secondary insurance may fill in the 20%. Some people may prefer to rent as it allows for rental payments over 13 months. After the first 13 months, the bed is considered paid in full and no further payments are required.
Are Adjustable Beds Covered by Medicare Available Commercially?
Participating suppliers in the Medicare program are able to fulfill the need for a hospital bed if deemed medically necessary. Contracted suppliers are used to keep the health care costs down. The amount Medicare pays is pre-negotiated. Adjustable beds purchased outside of this network are not covered by Medicare. Some medical supply companies and furniture stores may mislead patients without meaning to. It is possible that their representatives mistakenly believe a product or service is covered when it is not. It is always best for those enrolled in Medicare to contact the plan directly for pre-authorization.
The Issue of Medicare Reimbursement
Some medical equipment suppliers will expect to be paid up front which can make it difficult for patients. Medicare is billed, but not typically able to be paid prior to bed pick up. Knowing that the money will be reimbursed doesn’t make it any easier to fit the large expense into a budget. Many people who have this type of coverage are on a fixed income as well. So coming up with money to fully fund an adjustable hospital bed up front may just not be possible.
Medically Necessary
Just because your physician determines there is a medical purpose for equipment, doesn’t mean it will be approved. The doctor’s recommendation is considered but must be approved by Medicare before it will pay. Not all medical equipment is created equal. There may be a specific type that is approved while other variations will not be paid. This is similar to medicine prescriptions; some are approved with no problem, while others are not. Hospital beds may be covered, but not all are adjustable beds covered by Medicare.
Are Adjustable Beds Covered by Medicare Electric?
If you’re counting on Medicare coverage, don’t run out and purchase an electric hospital bed. Fully electric adjustable beds are not a covered benefit of Medicare. There are a large number of adjustable beds in the marketplace. Some of the fully electric beds have built in features that would make time in them more pleasurable. Massage specifically may be an advantage worth paying more for out of pocket. However, these beds have prohibitive costs for Medicare coverage and are not covered.
Why are Adjustable Beds Covered by Medicare?
There are many reasons why a physician would recommend an adjustable bed to a patient. The adjustable positioning addresses multiple health related issues. It can help relieve or reduce respiratory and circulation issues as well as chronic pain. Hospital beds can lower and rise for patients who have difficulty getting into and out of bed. These beds can offer mobility as well. Caretakers appreciate the impact one of these beds can have on the job of caring for the injured or ill.
Summary
Medicare, like most insurance, can feel complicated and at times overwhelming. It is a beneficial program that helps make medical care more accessible. The more you learn about its policies and procedures, the easier it gets to navigate. Thankfully, there are adjustable beds covered by Medicare. This article is provided as a resource. Information is constantly changing so after publication, the information provided may change. For the most up to date information, visit the official Medicare website.
Reference:
https://www.medicare.gov/coverage/hospital-beds
https://amadaseniorcare.com/2015/11/medicare/
