Medicare will put money towards certain adjustable beds in specific circumstances for your health. In other words, yes, they are covered. Here is more information you should know about adjustable bed coverage.
What Beds Medicare Covers
Under Medicare Part B, you have coverage for “necessary durable medical equipment” (DME). DME are items such as wheelchairs, walkers, and, of course, adjustable beds. But there are specific types of adjustable beds that Medicare covers. If the bed you want does not meet certain qualifications, all or a portion of it may not be covered.
Only adjustable hospital beds are considered DME. This means that it must allow a person to elevate different body parts as necessary, with adjustable side rails. This is the basic standard to meet DME requirements, but certain people have features or add-ons that are necessary to their health as well. Medicare will likely cover any additions recommended by your doctor. These often include:
- Air-fluidized beds
- Built-in weight scale
- Electric power adjustments
- Extra-wide hospital bed
- Gel or gel-like pressure mattress pad
- Lambswool, sheepskin, and synthetic pads
What Medicare Covers Them For
However, you cannot get a covered adjustable bed unless it is considered “medically necessary” by the plan. To qualify, you may have one of the following illnesses that have home hospital beds as a required part of treatment and/or recovery:
- You have a chronic pain condition, such as arthritis.
- You have a heart condition that requires you to keep your limbs elevated.
- You have a condition that requires you be repositioned for pain or pressure relief.
- You have a chronic obstructive pulmonary disease that’s affected by your sleeping position.
Specific illnesses alone are not enough to earn coverage. You must also meet one of the following requirements:
- Your documented medical condition requires a home hospital bed.
- You’re under the care of a doctor.
- You’re seen at least once every six months.
- Your doctor deems the bed as medically necessary for home use.
What Medicare Pays
Though Medicare will cover your adjustable bed if you meet these qualifications, it will not cover 100% of the costs. Part B uses a system known as cost-sharing, in which you cover the remaining costs that Medicare does not.
For an adjustable bed, Medicare will pay for 80% of the amount if it is Medicare-approved (i.e., you and the bed meet the above requirements). If you have a Medicare Advantage or supplement plan, it may cover more. The exact amount that comes out of your pocket will largely depend on the bed you purchase.
Understand Your Coverage with the Medicare Sharks
Adjustable beds are one of many benefits you receive through Medicare. There is a lot more you need to know to make the most out of your plan. To learn more and find a plan that suits you, call the Medicare Sharks at 561-225-3022 or 561-225-3633.