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Does Medicare Pay For Hospital Beds At Home

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State Assistive Technology Programs

Does Medicare pays for hospital beds?

Assistive Technology Programs, in all states across the US, have been designed to improve access to assistive devices in the home, primarily for the elderly and the disabled.

Most state Assistive Technology Programs have

  • an online exchange where people will post assistive devices and medical equipment, such as hospital beds as donations, or at very low cost state residents can just register on the exchange website, and participate at no cost for using the site
  • a main website where you can make contact and ask about how to get access to free equipment, and what the eligibility requirements are
  • reuse and refurbishment programs which are run by the state program, or partnered with community groups to help them provide free or extremely low cost equipment for the disabled, the elderly and other disadvantaged individuals sometimes the equipment is free, and in other cases you have to pay a little, depending on the individuals circumstances
  • some states have loan closets as part of their program, and particularly short term loans for checking that the equipment suited to an individual

Assistive Technology Programs will also make contact with individuals who enroll when they know that there is equipment available that the person needs.

You can find out about this on your state assistive technology program website.

To see what projects are in your state, click here.

How To Get Free Hospital Beds

There exist quite a few resources which you can use in your state to find out if you can get free hospital beds, if you put in some time.

Some funding sources will pay for a new hospital bed, or a refurbished bed, or you may find someone who is donating a bed they no longer need.

I have seen private individuals offering hospital beds for free on multiple occasions, so it is possible to find them.

Ways To Pay For Home Hospital Beds

by Piedmont Medical | Nov 28, 2019 | Uncategorized

In 2016, nearly 36 million Americans had a hospital stay. After discharge, many of these people rehabilitated at home. Moreover, about 4.5 million Americans receive long term home health care.

With so many people receiving health care services in the home, there is a huge demand for home hospital bed frames. Fortunately, there are many options for paying for home hospital bed frames. Here are five options:

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What Home Health Services Does Medicare Cover

Medicare covers specific types of home health care services, including:

  • Intermittent skilled nursing care: This could include injections, tube feedings, wound care, diabetes care, or patient and caregiver education.
  • Physical, occupational, or speech-language pathology therapy: To qualify for these services, they must be safe and effective for your condition. Additionally, the services must be complex and require qualified therapists to perform them.
  • Home health aide services and personal care: You must also be receiving skilled nursing care or therapy to qualify for these services.
  • Medical social services: If youre getting skilled care, you may also qualify for social services that a doctor deems necessary. These include counseling or connecting you with community resources.
  • Medical supplies: Medicare covers medical supplies, such as dressings for your wounds, if your doctor orders them.

Coverage for durable medical equipment works differently than home health care. The equipment your doctor orders, such as a wheelchair or a walker, must meet specific criteria. Based on that, Medicare typically pays 80% of the approved amount for the equipment.

Conditions That Require Frequent Repositioning In A Bed

Does Medicare Cover Hospital Beds? Complete Seniors Guide to Beds and ...

Many medical conditions, especially cardiovascular illnesses, require the patient to change their position in ways they cant achieve in an ordinary bed. These can include chronic obstructive pulmonary disease , and patients with severe cardiac conditions who can leave the bed but must avoid physical strain can also qualify for hospital bed coverage. These patients may need to have the head of the bed elevated more than 30 degrees due to their medical issues, but this usually comes after the doctor considers pillows or wedges and rules them out.

Hospital beds are specially designed to let users adjust their head and feet when needed, changing the pressure points and improving their bodys circulation. Qualifying for a hospital bed can depend on the severity and frequency of the symptoms that necessitate an adjustable model. If the reason for needing a hospital bed is that the patients condition requires frequent repositioning, the prescription and documentation must describe the medical condition.

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Who Qualifies For Home Health Care With Medicare

Medicare has several conditions in place for home health care. Anyone with Part A or Part B coverage who meets all of these qualifying factors is eligible:

  • You must have a doctor overseeing your care, and they must regularly review your care.
  • Your doctor must certify that you need intermittent skilled nursing care and/or therapy services
  • Your doctor must certify that you are homebound.
  • A Medicare-certified agency must provide your care.
  • You must meet face to face with your doctor or health care professionals who work with a doctor within the required time frames about your need for home health care.

Even when deemed homebound, you are still able to leave for medical treatment or for a short, infrequent nonmedical reason, such as a haircut, a religious service, or attending a funeral or family reunion.

Notice that you must seek care from Medicare-certified agencies. These agencies have agreed to be paid by Medicare and to accept only the Medicare-approved amount for their services. They cannot engage in balance billing. By using an approved agency, youll reduce your out-of-pocket costs.

Types Of Hospital Beds Covered By Medicare

A manual lift bed is covered by Medicare, while a full-electric bed is not. Total electric hospital beds are considered to be a convenience, not a necessity.

The hospital bed must also be a basic bed, which refers to its size and shape. A basic bed is very close to a twin-sized bed.

Some larger beds may be covered for individuals depending on their weight. Larger hospital beds are known as bariatric or heavy duty beds and are addressed in their dedicated section below.

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How Do I Know If Mattresses Covered By Medicare Are Best For Me

The pressure-relieving mattresses that are covered by Medicare arent the best choice for everyone. There are a few questions that you need to answer before determining if a Medicare-approved mattress is right for you.

  • Does your medical condition require that your body is positioned in a way that is impossible with a normal mattress?
  • Is it not feasible for you to use a regular mattress to reduce pain?
  • Does your head need to be elevated 30 degrees or more in a manner that isnt possible with a pillow or wedge?

If you answered yes to any of those questions, then a Medicare-approved mattress such as a Thevorelief Pressure Relief Mattress, Defend Pressure Relief Mattress, Joerns Prevamatt Defend Pressure Relief, Solace Resolution Glissando Heavy Duty mattress, or other therapeutic 5-zone support mattress may be best for your needs.

Its important to note that normal memory foam mattresses may cause back pain for some people. If that applies to you, then you may need one of the special mattresses listed above that are covered under your health plan.

Its important to note that the best mattress for you will depend on your unique needs. There is no single brand that is best for everyone.

Which Medicare Plans May Be Best For You If You Know You Need A Hospital Bed At Home

Medicare : Will Medicare Pay for Adjustable Beds?

You can get coverage for hospital beds through a few different parts of Medicare.

If you use Medicare parts A and B, together called original Medicare, your coverage will be through Medicare Part B. Thats because Medicare Part A covers inpatient stays and care you receive in hospitals and skilled nursing facilities.

  • emergency room care
  • medical equipment

Part B will cover 80 percent of the Medicare-approved amount of your hospital bed. Youll pay the remaining 20 percent.

You can also get coverage through a Medicare Part C plan. Part C plans, also known as Medicare Advantage plans, are offered by private companies that contract with Medicare.

Theyre required to provide the same coverage as original Medicare. Plus, many Advantage plans go beyond the coverage of original Medicare to offer additional covered services.

So, since original Medicare covers hospital beds, all Advantage plans will also cover hospital beds. Your cost might be more or less than with original Medicare, depending on your plan.

Medicare Part D is prescription drug coverage. It wont help you pay for any DME, including hospital beds.

Medigap, however, can help you pay for a hospital bed. This is Medicare supplement insurance. It covers some of the out-of-pocket costs of using original Medicare, like copayments and coinsurance amounts.

So, if you use Medicare Part B to get a hospital bed, a Medigap plan could cover the 20 percent coinsurance amount youd normally need to pay.

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Does Insurance Cover The Cost Of A Hospital Bed

If you are wondering how to get a hospital bed at home then you’re probably also wondering if Medicare covers hospital beds? If so, we have good news. Medicare does cover hospital beds as long as you meet certain requirements.

Here are the basic requirements to get insurance coverage on your bed:

  • You must be covered under Medicare Part B.
  • You must be assessed by your doctor and receive a prescription for the bed.
  • You must have a medical need for the bed. For instance, you:
  • need to lay or sleep in certain positions to relieve pain and cannot lay or sleep in those positions in a normal bed.
  • have congestive heart failure, breathing problems, or other ailments that require you to sleep with the head of the bed higher than thirty degrees.
  • use traction equipment that needs to be attached to a hospital bed.

Your doctor will know if there are any other criteria needed for you to qualify for a hospital bed. Be sure to talk to him/her for more information about insurance requirements.

Medicare To Cease Reimbursement For Bed Sores Pressure Sores And Decubitus Ulcers

Last year, the Centers for Medicare and Medicaid Services announced that it will cease reimbursement for hospital care of eight reasonably preventable conditions including pressure ulcers, bed sore aka decubitus ulcers in October 2008.

Which is understandable, since the number of hospital patients develop pressure ulcers, bed sores and decubitus ulcers year increased by 63% over the last 10 and nearly 60,000 deaths annually from hospital-acquired bed sores, pressure sores and decubitus ulcers.

But this is not the only victim. According to the Agency for Healthcare Research and Quality, the average length of stay for patients hospitalized for treatment of Hospital-acquired pressure ulcers, bed sores and decubitus ulcers was 13 days, each with an average cost of $ 37,500 U.S. dollars stay.

If a patient is immobile bedridden or has difficulty moving after surgery or procedures, the minimum friction burns with blankets, wheelchairs or other areas can quickly become established in pressure ulcers. One problem is that pressure ulcers, bed sores and decubitus ulcers can be initially difficult to see that look sometimes seen as nothing more than a pink or red spot on inaccessible areas such as skin creases or bony.

So what can we do? We need to put the medicine in a proactive way to work through the transformation of our core protocols in prevention programs for pressure sores, bed sores and decubitus ulcers.

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How Can You Get Approved For A Hospital Bed

In order to get approved for a hospital bed, you need a doctor to prescribe one for you. Speak with your primary care physician about getting a hospital bed. If the doctor agrees that you have a medical need for the device, Medicare is likely to approve the expense.

Your doctors office is unlikely to have a bed you can take home, but they may have a referral for you to a medical supplier who can deliver the bed once payment is approved. Many hospital bed retailers offer free or reduced cost delivery services for seniors on Medicare. Because hospital beds are often somewhat more complex than a typical bed, many suppliers offer to assemble the bed for you at the time of delivery.

What Parts Arent Covered

Is a Medical Bed Covered by Medicare?

There are some aspects of in-home care that are convenient and even sometimes necessary to help sustain certain lifestyles, but they arent all covered by Medicare. These services include:

  • 24-hour skilled nursing care: If you or a loved one needs this, you may be better off in a skilled nursing home facility, which Medicare does cover.
  • Meals delivered to your home: While there may be aides who help do this in your home, you will not be reimbursed for having meals brought to you because you cant leave the house.
  • Custodial care when its the only service you need: Custodial care refers to any non-medical help you need, such as with bathing or getting dressed. However, this type of care could be included in your plan if your doctor deems that its necessary to improve your condition.
  • Homemaker services: This includes activities such as shopping, cleaning, and laundry, as described by the Medicare website. This also could be covered if they are related to your home health plan prescribed by your doctor.

So now that we know what Medicare covers , lets discuss how you can qualify for in-home care.

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No Prescription Or Doctors Order

As a rule of thumb, Medicaid will not cover anything UNLESS you will present a prescription issued by your doctor that shows you really need the medical equipment. The doctors order or the prescription must include the following important information:

  • Date of the prescription
  • Signature of the doctor
  • Doctors license number

Aside from your doctor, here are other qualified personnel that can issue you a prescription for your needed medical equipment:

  • Physicians assistant
  • Podiatrist
  • Advanced registered nurse

In some other cases, wherein, for example, you are staying in a home health agency, the process might be a bit different, yet almost the same principle. For you to qualify for durable medical equipment, you must talk to your agency so that they can create a plan of care. Once you have prepared the plan of care have it signed to any of the following qualified personnel mentioned above.

How Much Does It Cost To Rent Or Buy A Hospital Bed

After you have paid your annual deductible, you will pay 20% of the Medicare-approved amount for the hospital bed purchase or rental and maintenance. If you have Supplemental insurance you may have little to no out-of-pocket cost for a manual crank, or a semi-electric Hospital bed.Those costs may be higher if the supplier doesn’t accept assignment. Hospital beds are in the Capped Rental category, which means you may choose to rent or purchase the bed. Once Medicare has made 10 monthly rental payments you will be given an opportunity to purchase the bed. The supplier will send you a “Purchase Option” letter in the ninth month of the rental. You will have 30 days to reply.If you reply and want to buy the bed:

  • Medicare will make three more payments and the bed is yours.
  • You will be responsible for maintenance .

If you do not answer or choose to continue renting:

  • Medicare will make a total of 15 rental payments and the bed is yours to use as long as you need it.
  • The supplier keeps ownership of the bed and is responsible for maintaining it.
  • You may be charged a maintenance and service fee every six months.

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How Much Does A Hospital Bed Cost With Medicare

If Medicare covers your hospital bed , there are some out-of-pocket costs you may need to pay, which may include:

  • Part B deductibleIn 2020, the Medicare Part B deductible is $198 per year.
  • Part B coinsurance or copaymentAfter you meet your Part B deductible, you typically pay 20 percent of the Medicare-approved amount for most doctors services.There is no annual limit on how much you could pay for the Part B coinsurance in a given year.

We recommend speaking with your doctor directly for specific cost and coverage information related to your hospital bed.

Do Charities Give Away Hospital Beds

Hospital Beds: Coverage Criteria

There are multiple Non-Profit Assistance Programs for durable medical equipment. These Non-Profits can be divided into 3 groups: National Foundations, Local Non-Profits, and Lost Limb Organizations. National Foundations usually require the user to have a specific diagnosis to participate. Local Non-Profits usually accept donated equipment, and re-sell them at little to no cost. Additionally, there are low-income relief programs that offer free, used medical equipment.

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What Is Durable Medical Equipment

Durable medical equipment is described by Medicare as equipment that is required by a physician. DME helps Medicare subscribers with care for important health issues. Common items that qualify as durable medical equipment include insulin monitors, ventilators, oxygen equipment, and breath test tubes. This equipment is needed to manage long-term health conditions.

A medical device such as a pressure-relieving mattress must comply with all requirements and regulations in order to be eligible for Medicare coverage.

Free Help With Understanding Medicare

SHIP State Health Insurance Assistance Programs

Medicare, Medicaid and Medigap free counseling over the phone is available from your SHIP if you need help.

I have a short article which outlines how to find your SHIP, which you can find that here Free Help Understanding Medicare And Medicaid ? Heres Where You Get It.

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