An adjustable bed for seniors dealing with medical conditions can be a lifesaver. Yet the hefty price tag associated with these beds often makes it difficult for them to purchase one. Fortunately, Medicare benefits can help cover some of the cost.
Adjustable beds, often referred to as 'hospital beds' in the medical world, look like those in hospitals. Unfortunately, Medicare does not assist with the more luxurious adjustable beds primarily used for comfort. However, in certain cases, Medicare may assist in paying for a hospital bed.
Medicare Coverage
Having a hospital bed can be a life-changing experience, but before you can enjoy the benefits, you need to make sure you're subscribed to either Part B or C of Medicare (Medicare Advantage). Signing up isn't automatic, so you'll need to check with your doctor or provider to determine if you're eligible for coverage. Once you're approved, you'll be well on your way to making the most of your hospital bed.
Basic Eligibility Requirements
Medicare will not give any form of DME, including hospital beds unless it is critically necessary for the patient. It must be ordered and noted by a doctor and come from a face-to-face medical exam within half a year before applying to Medicare for compensation. Concerning Medicare regulations, they generally accept hospital beds as a reimbursable medical requirement merely if any of the following conditions are satisfied: - The recorded medical ailment necessitates placing the body in manners not achievable with a traditional bed. - The patient requires that the head of the bed be raised beyond 30 degrees, predominantly due to congestive heart failure, chronic pulmonary disease, or issues with swallowing. - Pillows or wedges should have been assessed and discarded. - The patient needs medical apparatus that can only attach to a hospital bed. To be eligible for Medicare reimbursement of a hospital bed, your physician must order it following a face-to-face examination, noting the medical necessity of the bed within the last six months.
Types of Hospital Beds and Specific Eligibility
Manual hospital beds are the go-to choice for those seeking an affordable way to receive medical care. Medicare makes these beds accessible to those who meet their specific eligibility criteria. This type of bed is easily adjustable, with a simple hand crank that can raise or lower the head and foot of the bed. Other types of hospital beds include:
- Variable Height Beds – These adjustable beds can be obtained if you meet the basic qualifications and require an elevation different from a pre-set height hospital bed. Easily transition from bed to chair, wheelchair, or upright stance with a simple hand crank. - Semi-Electric Hospital Beds – Get the perfect position for sleep or relaxation with these beds that can be covered if you meet the basic requirements and require frequent adjustments in body position or need to quickly alter your body position. - Heavy Duty Extra-Wide Medical Beds – These beds can be covered if you meet the basic requirements and your body weight is over 350 lbs but does not surpass 600 lbs. Easily move from bed to chair, wheelchair, or upright stance.
If you are looking for a complete electric bed, it may not be covered by Medicare as they consider it to be more of a convenience than a necessity.
Monetary Details
If Medicare approves your application for a hospital bed, the following are the financial specifics entailed: - Any out-of-pocket sum on your Medicare Part B or C will be considered before any reimbursement is granted. - Medicare will finance the bed purchase provided proof of a long-term requirement (at least six months). - Should the requirement be only for a brief period, they will simply cover the cost of a rental for the bed.
You could take advantage of Medicare's "lease with an option to purchase" option for beds, allowing you to rent for 13 months and have the option to own it after that period. You'll be responsible for the remaining 20%.
Special Considerations
If you need a hospital bed in your home, it is important to consider a few special considerations. Medicare may approve a hospital bed to be placed in your home, a relative's home, or a nursing home if that is where you live. If you need the bed for an extended period of time, Medicare can provide you with a renewal every five years. However, you must ensure that you have received Medicare's approval before purchasing or renting one.