We may use a few terms in this article that can be helpful to understand when selecting the best insurance plan:
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This article looks at Medicare coverage requirements. It also examines the costs and financial assistance.
For people with certain medical conditions, such as a broken hip or paraplegia, an adjustable bed can mean greater comfort and a lower risk of further injury.
Medicare covers different types of durable medical equipment (DME), which may include an adjustable bed if a person meets the criteria.
In general, doctors do not consider an adjustable bed useful or necessary for a person who is not sick or injured. According to Medicare&#;s definitions, lounge beds &#; whether they use manual or electric power &#; are not DME.
However, there are different types of adjustable beds, and Medicare does not cover them all. For Medicare to consider an adjustable bed as DME, the bed must:
Medicare considers prescribed adjustable beds, including hospital beds , as DME. Therefore, it may cover the cost as long as a doctor certifies that a person needs the bed for home use.
Part B also covers some medical testing and some medications, such as infusions or vaccinations.
Medicare divides its coverage into parts, with each part offering coverage for different aspects of healthcare.
Medicare may cover part of the cost for necessary modifications to a person&#;s adjustable bed, such as having an air-fluidized bed for reducing pressure. Other Medicare-covered adjustments may include :
The bed should also have side rails that an individual can lower or raise.
Medicare will only consider an adjustable bed as DME if it adjusts either from the head or foot, allowing a person to elevate different body parts as necessary.
Examples of conditions for which people may need an adjustable bed include:
In the prescription, the doctor must describe the person&#;s condition and diagnosis to explain why the adjustable bed is medically necessary.
According to the eligibility requirements , the bed is a medical necessity if a person needs:
For someone to be eligible for an adjustable bed that qualifies as DME, their doctor must write a prescription stating that the bed is medically necessary.
Although Medicare helps pay for adjustable beds, a person is usually still responsible for paying a portion of the costs. Various factors can also affect the costs, such as the type of bed and the rental or purchase terms.
The person must rent or buy the bed from a supplier that accepts Medicare assignment. This means the supplier agrees to the price Medicare sets for renting or purchasing the equipment.
If someone purchases or rents a bed from a supplier that does not accept Medicare, that supplier may charge more than the Medicare-approved amount, and Medicare will not cover the cost.
If a person rents the bed, Medicare covers the monthly payments, and the supplier covers the cost of repairs. Medicare will cover the rental costs for 13 months of continuous use. After this time, the supplier must transfer ownership to the user.
To find a supplier, a person can use Medicare&#;s online tool or call 1-800-MEDICARE (1-800-633-).
Many different adjustable beds are available, with various options for purchase or rental.
Cost factors will include:
After a person&#;s doctor certifies that a bed is medically necessary and the person obtains it from a Medicare-approved supplier, they will pay 20% of the Medicare-approved amount.
If a person has not met their Medicare Part B deductible, it will apply to the purchase or rental. For , the Medicare Part B deductible is $257.
Medicare classifies hospital beds as durable medical equipment (DME), which is covered by Medicare Part B. Learn about eligiblity and out-of-pocket costs.
Medicare will pay for a hospital bed purchase or rental if it's considered medically necessary and prescribed by a doctor, and provided by a medical equipment provider approved by Medicare.
Medicare classifies hospital beds as durable medical equipment (DME), which is covered by Medicare Part B. However, there are some requirements you must meet for Medicare hospital bed coverage.
Additionally, even if Medicare does cover your hospital bed, there are some out-of-pocket costs you'll likely face. Learn more about your coverage.
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Yes, Medicare will pay for hospital beds, if you meet certain conditions. Medicare does cover the cost of renting a hospital bed or purchasing one for home use if:
According to Medicare.gov, "Doctors and suppliers have to meet strict standards to enroll and stay enrolled in Medicare. If your doctors or suppliers aren't enrolled, Medicare won't pay the claims submitted by them."1
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1-800-995-
If your hospital bed rental or purchase is approved for Medicare coverage, you pay 20 percent of the Medicare-approved amount of the hospital bed, and Medicare pays the other 80 percent.
Before Medicare will pay its share, however, you must first meet your Part B deductible. In , the standard Medicare Part B deductible is $240 per year.
Medicare covers hospital bed rentals and purchases. After 13 months of renting your hospital bed, you will officially own it under current Medicare rules. The specific cost of your hospital bed may depend on factors such as:
Your doctor can tell you more about how much you'll likely pay for your hospital bed under Medicare.
Under Medicare's Competitive Bidding Program, DME suppliers submit bids to provide equipment to Medicare recipients living in or visiting competitive bidding areas. If you have Original Medicare and live in or are visiting a state in a competitive bidding area, you must get your DME from a contract supplier.
Refer to Medicare.gov to find out if you live in a competitive bidding area.
Or call now to speak with a licensed insurance agent:
1-800-995-
Medicare Part A covers inpatient hospital stays, as well as skilled nursing care, hospice care and limited home health services.
As an inpatient at a hospital, your Medicare Part A coverage includes the following:
Semi-private rooms
Meals
General nursing
Inpatient treatment drugs
Care as part of a qualifying clinical research study
Other hospital services and supplies
Not included are things like private-duty nursing, most private rooms, personal care items and television and services.
Before Medicare Part A will pay its share of a hospital stay, you must first meet your Medicare Part A deductible &#; $1,632 per benefit period (in ).
For lengthy hospitalizations, you may have to pay coinsurance based on the length of your stay (all costs listed are for ):
Days 1-60: $0 coinsurance
Days 61-90: $408 coinsurance per day
Days 91 and beyond: $816 coinsurance per each "lifetime reserve day." You have 60 lifetime reserve days.
Beyond lifetime reserve days: All costs.
Or call now to speak with a licensed insurance agent:
1-800-995-
Medicare Supplement Insurance plan (Medigap) helps pay for out-of-pocket costs associated with a hospital stay.
All Medigap plans offer coverage for the following hospital benefits:
Medicare Part A coinsurance and hospital costs
First three pints of blood if needed for a transfusion
Part A hospice care coinsurance or copayment
Some Medigap plans may also include coverage for:
Coinsurance for skilled nursing facility stay
Medicare Part A deductible
With 10 standardized Medigap plans to choose from in most states, you can find one that meets your needs. Call today to speak with a licensed insurance agent who can help you compare Medigap plans that are available where you live.
Important: Plan F and Plan C are not available to beneficiaries who became eligible for Medicare on or after January 1, .
Or call
1-800-995-to speak with a licensed insurance agent.
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