Monday, May 9, 2022

How Do I Get A Lift Chair Through Medicare

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Cost Of Lift Chairs Through Medicare

Does Medicare Pays For Lift Chairs?

Lift chairs can be expensive, typically ranging from $400 to $2,000 depending on the supplier and any additional features. Median lift chair costs are about $700.

Theres good news, though. If you have a prescription and purchase through a Medicare-participating supplier, you should be reimbursed for 80 percent of the cost of the chairs motorized lift. This usually reduces your overall cost by about $300, meaning your out-of-pocket costs for a lift chair could potentially be as little as $100. If you purchase a chair at the median $700 price point and receive the average $300 reimbursement, the total cost will be approximately $400. If you have any additional insurance or discounts, these may help lower your final cost as well.

Remember, you must meet your Medicare Part B deductible before Medicare begins paying 80 percent for approved products and services. If you havent already reached your deductible, expect to pay $203 in 2021 before you receive your 80 percent coverage.

How Can A Lift Chair Help Me

Lift chairs for the elderly can help you stand up or help you lay back into a relaxing position. Some lift chairs can recline fully back to allow you to lie down and tilt steeply forward to help you get up. A lift chair for the elderly may be helpful for people who struggle to shift positions unassisted. Your doctor may prescribe a lift chair as medically necessary if you have a condition that could benefit from regular movement and your mobility would be difficult without the device.

How To Get A Medicare Reimbursement Check For A Lift Chair Seat Lift Mechanisms

Here are the steps and requirements to getting approved for a Medicare reimbursement.

  • If there is a green check next to your physicians name, he/she is enrolled in PECOS. His/her NPI is listed to the right of his/her name. In this example, Lawrence Foe is enrolled in PECOS and his NPI is to the right of his name in blue.

    Double check to make sure your physician has a valid National Provider Identifier and is enrolled in the Medicare Provider Enrollment, Chain and Ownership System . Only NPI and PECOS physicians can write prescriptions that are covered by Medicare.

    You can check by typing in your physicians name in .

  • Make sure you are on Medicare part B.
  • You have a prescription from your physician for a lift chair.
  • You meet the following 4 criteria that determines if a lift chair is a medical necessity: A. You have severe arthritis in your knee or hip or you have a neuromuscular condition. B. The lift chair must be apart of a course of treatment and is prescribed to arrest, retard, or improve your condition. C. You must be unable to stand up from a regular arm chair or any chair in your home. D. When you stand, you are able to walk.
  • , also known as the Lift Chair Medicare Form or Reimbursement Form, fill it out and have your physician fill it out.
  • Go to your local Medicare office with your CMS-849, prescription, and lift chair receipt.
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    Are Lift Chairs Covered Under Medicare

    Lift chairs are covered by Medicare Part B and Medicare Advantage plans. They are categorized as durable medical equipment and are covered under Part B along with other DME items like walkers and wheelchairs.

    The part of the chair that is covered by Medicare is the motor and accompanying device that helps you lift out of the chair.

    Lift chairs that use a spring device to lift you out are not covered by Medicare. And the fabric, cushion and any accessories are also not covered by Medicare.

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    Will The Va Pay For A Lift Chair

    VAwill paylift

    . Just so, does the VA provide lift recliners?

    Yes they will, if a VA physician can show a medical necessity for such a chair. I went to the VA prosthetic department with my primary care physicians referral for a lift recliner .

    Secondly, does the VA pay for durable medical equipment? VD-HCBS, also known as Cash and Counseling for Veterans, is a program managed at the local VA Medical Center, that provides veterans with a care budget and allows them to self-direct their services and supplies. As such, the program will pay for durable medical equipment that is medically necessary.

    Herein, how do I get Medicare to pay for a lift chair?

    While Medicare typically won’t pay for a lift chair in full, Medicare Part B or Medicare Part C may cover the seat-lift mechanism as durable medical equipment if your doctor determines that it’s medically necessary and will help your condition.

    What is the best lift chair for the money?

    Best Lift Chairs 2020

    • Merax Power Recliner and Lift Chair Best Overall.
    • ProLounger Lya Cream Renu Leather Power Recline and Lift Wall Hugger Chair Best for the money.
    • Coaster Home Furnishings Casual Power Lift Recliner Best for easily assembled.
    • Mega Motion Lift Chair Easy Comfort Recliner Best for bedroom with little space.

    How Do I Qualify For A Lift Chair

    Medicare will pay for a lift chair Medicare may cover the seat lift mechanism of a lift chair if these criteria are met.

    Medicare coverage: Medicare Part B , or a Medicare Advantage Plan, must be in place. Talk to your private insurance company provides to learn about the costs and coverage requirements for obtaining a lift chair if you get your Medicare benefits through Medicare Advantage Plans.

    Because Medicare Advantage companies must cover all aspects that original Medicare does, you should get at least the same amount of coverage, if not additional benefits.

    A certificate stating medical necessity: To obtain prescription drugs for the lift chair, you must make an appointment with your doctor. Sections B and D must be completed on a Certificate of Medical Necessity for Seat Lift Mechanisms form, also known as Medicare form CMS-849.

    Determining medical necessity: If the following conditions are met, a seat lift mechanism might be considered medically required.

    • The patient lifts may have severe arthritis in the knee or hips or a severe neuromuscular disease
    • The patient lift is totally incapable of standing from a regular chair.
    • Standing, the patient is able to walk independently or with the assistance of a cane or walker. Medicare may not pay for a wheelchair if the patient transfers directly to it.
    • The physician uses the seat lift mechanism to treat the patient.

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    How Do I Find Approved Lift Chairs Medicare Suppliers

    Medicare has specific rules about coverage for lift chairs and other durable medical equipment. First, both the doctor who prescribes the equipment and the supplier who provides it must be enrolled in Medicare. Your doctor or other health care provider should be able to give you a list of approved suppliers in your area, or you can use the supplier locator tool on the Medicare website.

    Depending on where you live, lift chairs and other devices may be under the Medicare Competitive Bidding Program. This is a cost-saving program that helps Medicare enrollees get the lowest prices on their covered devices. If you live in an area where the Competitive Bidding Program is in place, you can only get your lift chair from an approved supplier, even if there are other suppliers in the area that accept Medicare assignment.

    Do you have more questions about Medicare coverage of lift chairs? Feel free to contact eHealths licensed insurance agents at the number below. Or just enter your zip code on this page to begin browsing plans.

    Medicare information is everywhere. What is hard is knowing which information to trust. Because eHealths Medicare related content is compliant with CMS regulations, you can rest assured youre getting accurate information so you can make the right decisions for your coverage. Read more to learn about our Compliance Program.

    Are Patient Lifts Covered By Medicare

    How To Get a Lift Chair Covered by Insurance

    Medicare Part B may cover a patient lift for you to use in your home if medically necessary and prescribed by your doctor. To be eligible, your doctor must determine that the device is medically necessary because:

    • Your health condition would be improved by moving periodically. Or, a patient lift would help slow or stop your condition from getting worse.
    • You need help moving from a bed to a chair, wheelchair, or toilet, and without the patient lift, you would be confined to a bed.

    If you get your Medicare Part A and Part B benefits through Medicare Advantage , keep in mind that Medicare Advantage plans must cover at least the same level of coverage as Original Medicare . So, if youre enrolled in a Medicare Advantage plan and meet the Medicare criteria for a patient lift, your plan should cover it just as Original Medicare would cover it.

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    How Much Does It Cost To Rent Or Buy A Patient Lift

    After youve paid your Part B annual deductible, youll owe 20% of the Medicare-approved amount to either buy or rent the patient lift.

    Make sure that the supplier you get your patient lift from is enrolled in the Medicare program and is a participating supplier. A Medicare-participating supplier agrees to always accept assignment, meaning the company wont charge you higher than the amounts set by the Medicare program. Youll still need to pay your share of the costs, such as deductibles or coinsurance. A non-participating supplier may charge more than the Medicare-approved amount for the patient lift, but cant charge more than 15% above the Medicare-approved amount. You may be asked to pay the entire bill when you pick up the patient lift.

    If youre enrolled in Original Medicare and live in an area thats part of Medicares Competitive Bidding Program, you may need to use certain contract suppliers or Medicare may not cover the cost. You can look up if your area is part of the program by visiting Medicare.gov or calling 1-800-MEDICARE , 24 hours a day, seven days a week.. TTY users should call 1-877-486-2048.

    Alternatives To Stair Lifts

    Stair lifts, without financial assistance, can be beyond the reach of many families. Unfortunately, there are very few less expensive alternatives. One option is to install handrails on both sides of the staircase. This narrows the staircase considerably, allowing stair climbers to stabilize themselves from both sides simultaneously. The handrails should extend one foot beyond the top and bottom of the stairway. Though obviously not perfect, this solution should cost less than $200 installed.

    A second option is sliding stair rails. These are grab bars, which slide and lock into position in front of the stair climber and move along as they climb or descend. One manufacturer of these products is called StairAid. StairAids, though still fairly expensive, cost approximately 50 percent less than an electric stair lift.

    A third option is Stair Blocks. These are blocks approximately one-foot-wide, the width of a stair and one-half the height of a stair. A block is placed on each step and when a user climbs, they alternate between the regular stair and the block. Stair blocks make climbing easier, but the individual still must climb and may still experience a fall. See a video.

    Lastly, there are vertical or inclined platform lifts, perhaps better thought of as elevator lifts. Typically, these cost more than stair lifts but can accommodate persons confined to wheelchairs. Learn more.

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    Are Lift Chairs Covered By Medicare

    Lift chairs are considered durable medical equipment and may be covered by Medicare if specific criteria are met:

    • The beneficiary must have coverage through either Medicare Part B or Medicare Advantage.
    • The device was prescribed by a Medicare-approved physician or a Certificate of Medical Necessity was obtained.
    • The chair must be purchased at an approved supplier that accepts Medicare assignment.

    Enrollees who live in skilled nursing facilities do not qualify for lift chairs through Medicare. These plans also wont cover lift chairs for beneficiaries who have previously used benefits to cover scooters or power or manual wheelchairs unless a physician verifies that your mobility has improved sufficiently.

    Enrollees who have Medicare Advantage should consult their providers for more information about coverage through their individual plans.

    What Kind Of Lift Chair Should You Get And Where Can You Get One

    Medicare Reimbursement For Your Lift Chair

    Now that you know what lift chairs are and the stipulations surrounding one being covered by your plan, its time to settle on which type of chair you want. As we discussed, there are three main types of chairs: two-position, three-position, and infinite-position. Obviously with Medicare in play, youre limited in the scope of lift chairs that you can get without paying too much money out of pocket. Each version comes at different price points.

    It is also advised that you get a lift chair from a Medicare-approved supplier. To find out approved suppliers in your area or online, contact your local Social Security office and compile a list of who you can buy from.

    Its difficult to say that one style of lift chair will cost a certain amount of money, though we can guarantee infinite-position chairs will typically cost the most and two-position chairs generally cost the least.

    Stressed about home care?

    The overall price stems from the type of fabric you want, how much cushion you want for your chair, how big the chair is , and other important factors. As a result, getting a top-of-the-line two-position chair may end up costing more your basic-level infinite-position chair. So, instead of just saying you should get X lift chair for Y amount from Z place, lets run through some steps you can take when finding the right lift chair for you.

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    How Much Do Lift Chairs Cost Through Medicare

    If you qualify, Medicare will pay 80% of the cost of the motorized lifting device. Youll pay your Part B annual deductible, the remaining 20% for the device and the cost of the chair itself. The total amount you pay can depend on any other insurance you have, where you get the lift chair and more.4

    Medicare Part B Coverage

    Obviously, securing the right coverage is the first step before purchasing a lift chair that Medicare will reimburse you for. This includes enrolling in Medicare Parts A and B, paying your monthly premiums, and meeting your annual deductible.

    Once you meet your $203 deductible, Medicare Part B will cover 80 percent of Medicare-approved DME purchases. In the case of a lift chair, this means Medicare will reimburse you for 80 percent of the cost for the lifting tool that the lift chair uses. Unfortunately, the government does not consider the chair portion of a lift chair to be medically necessary, which means youll be financially responsible for the cost of the actual chair and 20 percent of the cost for the lifting system.

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    How Do I Get A Lift Chair Through Medicare

    If you want to get a lift chair through Medicare, the first step is to get a doctors prescription or Certificate of Medical Necessity. This may require an in-person visit to your physician.

    Once youve obtained the prescription, find a Medicare-approved supplier who can match you with the appropriate chair. This supplier may need your physician to fill out additional paperwork that answers questions about your condition. Once youve chosen a chair, the supplier will submit your Medicare claim. Depending on your needs, Medicare may dictate whether you can purchase a lift chair or must rent the unit.

    Purchasing Used Stair Lifts

    Need a wheelchair? New Medicare rules mean fewer choices

    Unlike many home medical products, purchasing a stair lift used makes good sense. The designed lifespan for most stair lifts is approximately ten years, and the average stair lift is only used in the home for three years. For those paying out of pocket, buying used can save 25% 50% off of purchasing the product new. Buyers can expect a product price of between $500 and $1,500 for a used stair lift. It should be emphasized that unless one is buying from a professional refurbisher, this price very likely does not include installation.

    One challenge, when buying used, is with curved staircases. It is much easier to match a straight staircase stair lift to a different house. With curved staircases, very few are exactly alike and buyers may be required to purchase additional pieces of track from the manufacturer to make the stair lift fit their home.

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    Does Medicare Advantage Cover Lift Chairs

    Medicare Advantage is simply an alternative way to get the Medicare benefits provided by Part A and Part B. If you enroll in a Medicare Advantage plan, the plan may cover lift chairs under the durable medical equipment benefit.

    If you have a Medicare Advantage plan, you might have additional benefits not available under Part A and Part B. Medicare Advantage plans are offered by private insurance companies, and once they meet minimum coverage requirements, the insurers are able to offer extra coverage for things such as routine vision and dental coverage.

    Medicare Advantage plans are allowed to offer extra home health benefits that may be helpful for people with lift chairs. For example, some Medicare Advantage plans might cover home health aide services for custodial care and housekeeping assistance, as well as non-medical transportation to and from medical appointments. Plans are also allowed to offer an annual allowance for home safety equipment and devices such as wheelchair ramps and pull bars.

    Plans are not required to offer these supplemental benefits, so youll want to compare plans if youre interested in this coverage. Depending on where you live, you may be able to enroll in a plan with these extra benefits to help you live independently at home.

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