Does Medicare pay for adjustable beds 2019? Yes, Medicare provides coverage for the purchase or rental of adjustable beds for home use as long as the bed is deemed “medically necessary” by your doctor. Adjustable beds are considered to be “durable medical equipment” (DME) and are covered by Medicare Part B along with many other types of DME.
As long as your supplier of the bed accepts Medicare assignment, you will be responsible for 20 percent of the cost while your Medicare insurance will cover the remaining 80 percent. The Medicare Part B deductible (which is $183 per year for 2017) applies.
The cost of an adjustable bed can be covered in full with the help of a Medicare Supplement Insurance plan, which can cover both the 20 percent coinsurance and the Part B deductible.
What Is DME or Durable Medical Equipment?
DME or durable medical equipment is medical equipment which is rendered reusable; they can range from crutches, walkers, wheelchairs, or even adjustable beds. For those who have Medicare Part B, the provision will cover specific medically necessary DME or durable medical equipment if your doctor or healthcare provider requires that you use it at home.
In order for the DME to be covered, it has to be –
- Used for medical reasons
- Not usually of use to you if you are not hurt or sick
- It is used at home
When you reside or temporarily stay in a nursing home or hospital facility that is offering you Medicare-covered healthcare, these kinds of medical facilities do not qualify as your ‘home’, as per this particular definition. But, a long term health care facility can give you DME, as they are the one responsible for your health and overall care.
A few examples of DME that Medicare will cover can include the following: oxygen equipment, patient lifts, infusion materials, hospital beds, blood sugar monitor and ECG devices.
Where Do I Get a DME?
For your DME to be covered, you have to obtain your medical equipment from a certified supplier that is also enrolled in the Medicare program. The system will not pay for the equipment if they are not enrolled. To effectively lower the costs, you have to look for suppliers that are so-called ‘participating,’ which means that they have accepted the Medicare recommended costing for DME; otherwise, they will never charge you for that specific amount.
To be able to find Medicare-approved suppliers, check the Medicare website under the ‘Supplier Directory’, to find the list of accredited suppliers. If you currently live in a location that is part of their competitive bidding program, you will have to obtain the DME from health suppliers that are contracted by Medicare. For further information, check your location if it is part of the program, or check out Medicare.gov.
You can also check PPOs and HMOs as Medicare Advantage plans if they provide the same coverage as the original Medicare. Nevertheless, pricing can vary. It all depends on your Medicare Advantage plan. If you belong to a Medicare Advantage program, and you will need some DME, check with your plan to know if the equipment is covered and see how much you will have to pay.
Will My Medicare Cover Adjustable Beds?
Adjustable beds are covered by your Medicare. Medicare Part B, under the DME section explicitly allows cover for adjustable beds. But, as with any other insurance, there are certain requirements that must be met to qualify. First and foremost, the physician must prescribe the hospital bed for use at your home for your medical needs.
The moment a prescription is obtained, the bed must be sourced from an accredited Medicare supplier. Once all requirements have been met, the system will only cover a part of the expense. It is the role of the patient or the second medical insurance company to partially pay for the DME, which in this case is an adjustable hospital bed.
Will The Adjustable Beds Covered By Medicare Can Be Obtained Commercially?
Accredited suppliers under Medicare can fulfill the need for your adjustable hospital bed if they are medically necessary. Only Medicare accredited suppliers can help cut costs. The price of Medicare will shoulder is often pre-agreed by the parties.
Adjustable beds bought outside of the suppliers provided will never be covered by Medicare. Many bed suppliers mislead patients into buying from them without being accredited Medicare suppliers of DME products. It is very likely that their sales personnel do so in an attempt to meet their monthly sales quota. It is always important to check if the supplier is enrolled under the Medicare program to be able to collect later on.
Bed Is 100% Medically Necessary
Simply because your doctor finds it medically important you obtain a DME, does not necessarily follow that you will have the approval that you need. The findings by your doctor are necessary for approval into the program before Medicare pays you for it. But, not all DME are created equal.
There are some DME types that are not approved and will never be paid. This is very similar to medical prescriptions, there are some approved, while there are others that are not. Your adjustable hospital bed can be covered, however, not all beds can be covered by Medicare. Be sure to check on their website to confirm.
Does The Medicare Cover Electric Adjustable Beds?
If you are after Medicare coverage, never buy an electric powered adjustable bed. The fully electric powered hospital bed is not covered by Medicare. You will find a number of approved adjustable beds in the market today. Fully electric adjustable beds can have high-end features that many of us would prefer such as massage, heating, etc. But, these beds bear prohibitive costs for Medicare coverage and they are not allowed in the program.
Why Adjustable Beds are a Part of Medicare?
There are several reasons why doctors would suggest an adjustable hospital bed for a patient. The adjustable bed can help address various health and medical issues of patients. It can help cure, relieve, and minimize circulatory and respiratory health issues including moderate to severe pain. Adjustable hospital beds can help assist a patient get in and out of the bed comfortably and with ease. These beds allow more mobility than a regular bed would. Caregivers prefer adjustable beds when tending to medically problematic patients and it makes their job easier.
Do I Need A Prescription For My Adjustable Bed?
Those patients who can prove there is a medical need for obtaining an adjustable bed can get a prescription from their physicians for it. They can use these prescriptions and submit them to insurance companies or the Medicare program.
Inquire About This When Obtaining Medicare Coverage For Your Adjustable Bed
An adjustable bed can help minimize injury, reduce pain, and preclude death among patients, which is why they are medically necessary. Some insurers will help cover the costs of buying or leasing an adjustable bed, depending on the patient’s need and the kind of medical insurance coverage that they have. Oftentimes, Medicare never covers the cost of purchasing an adjustable bed.
Initially, they do not consider adjustable beds as an important DME, they would rarely add them to the coverage. But, there are patients who are part of Medicare Part B who had been successful in getting their purchase fees for adjustable beds reimbursed. So, always ask the question before you buy the adjustable bed if Medicare will cover and reimburse it for you.
How Much Coverage Will You Get?
The Medicare Part B will pay approximately 80% percent of the price of the adjustable beds rendered as DME or durable medical equipment that has been prescribed by a physician for home use. When the supplier agrees you furnish the adjustable bed, you will only pay the 20% of the hospital bed’s amount, and Medicare Part B will shoulder what remains of the cost.
Do I Have Medicare Part B?
Medical patients must ensure that they are currently part of the Medicare Part B program before getting a Medicare-covered adjustable bed.
Will They Shoulder Expenses For Accessories and Other Replacements?
Yes, Medicare will ensure that costs for replacements and accessories will be paid for if the hospital bed was bought from a Medicare-accredited supplier.
Can My Secondary Medical Insurance Cover My Adjustable Bed?
Prior to using your Medicare, it is vital that patients know whether or not their secondary medical insurance will cover the costs of the adjustable bed.
On The Matter of Medicare Reimbursement
There are DME or medical equipment suppliers that want to be paid for the whole amount of the DME which makes it taxing for patients. Medicare can be billed, but the bed may not be paid for immediately before bed pick up.
Patients may find it hard to pay for the cost of the bed, especially those who are already paying huge medical expenses as a result of their medical condition. For some, having the money to fully pay for the adjustable bed can be an issue.