What Type Of Medical Equipment Will Medicare Cover
Medicare coverage varies from state to state. In some states, Medicare will cover a specific type of medical equipment, while in other states, it wont.
Medicare usually covers Durable medical equipment helps you complete your daily activities such as walkers, wheelchairs, mobility scooters, hospital beds, portable oxygen equipment, prosthetics, and orthotics.
What Exactly Is A Lift Chair
A lift chair helps a person go from a sitting to standing position. The chair usually looks like a reclining chair, but it has the ability to rise or lift on an incline when you push a button.
Sometimes, lift chairs have additional features, such as heat or massage. Some chairs may even transform to a completely flat position, which would allow you to sleep in the chair as well.
With many additional features or upgraded upholstery materials available, the costs of lift chairs are also highly variable. Most chairs range from several hundred dollars to a thousand dollars.
Its important to note that a lift chair is not the same as a stair lift, which is a seat that takes you from the bottom to the top of a staircase by pushing a button. Its also not a patient lift, which helps caregivers transition you from a wheelchair to a bed or vice versa.
Will My Medicare Pay For A Lift Chair
Yes, Medicare Part B covers lift chairs. These chairs are considered Durable Medical Equipment and can be used to treat conditions such as arthritis, balance issues, or mobility problems. These standards should also be included in any Medicare Advantage plan. If you are currently residing in a hospital, skilled nursing facility, or nursing home facility, you won’t be eligible for a lift wheelchair. If Medicare has paid for a wheelchair, scooter, or another motorized device, you won’t be eligible.
Medicare pays the piece of equipment that “lifts” you from the seat. Chairs that have a spring device lifting you out of the chair are not covered by Medicare. Even though the device is embedded in the chair, it doesn’t cover the fabric, cushion, or other accessories.
Medicare will cover approximately 80 percent of motorized devices. You will be responsible for the remaining 20% and the cost of the rest of your chair. Supplemental Medigap plans can also cover the cost of all Medicare-inexpensive items. After you have chosen the chair that you like, you’ll purchase it and your provider will submit a Medicare claim.
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Who Is Eligible For A Lift Chair From Medicare
There are two main parts to a lift chair: the chair itself and the mechanical component that raises and lowers the seat. Medicare Part B only helps pay for the mechanical component, not the chair itself.
Below is a list of the requirements you must meet for Medicare to cover your lift chair.
- You must have severe arthritis or a severe neuromuscular disease in your knee or hip.
- You must be unable to stand up from a regular chair without assistance.
- The lift chair lift should be included in your treatment plan from your doctor and must be prescribed to improve your current condition or to stop it from getting worse.
- You can use the assistance of a walker or cane, but you do not use a wheelchair or scooter.
- Your doctor must be either the attending or consulting physician for the treatment of the condition.
IMPORTANT: Medicare only covers durable medical equipment if your doctor and your DME supplier participate in Medicare.
How Much Does Medicare Cover For A Lift Chair
Medicare only covers the seat lifting mechanism. It doesnt pay for the whole chair. Depending on the state you live in, the reimbursement amount may be around $300, and you would have to pay the rest. For most people with Part B Medicare coverage, that means paying 20% of the approved amounts when buying from a Medicare supplier.
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Three Types Of Lift Chairs Are Available
Two-Position Lift chair
This is the most basic of all three.
It can recline in two positions: A 90-degree upright position or a 45-degree position with the individual’s legs elevated and back at a recline.
The leg elevator and the reclining motor form one engine. This allows the chair to elevate as it reclines.
Three-Position Lift chair
The three-position lift chair has a 45-degree reclined and upright angle. It is similar to its two-position counterparts.
The chair’s reclining position allows for a nearly flat angle. The supine position relieves pressure on the back.
The chair’s components are all one motor like the two-position chair.
Infinite Position Lift Chair. The most customizable of the three medicare options, the infinite position chair is the best.
These seats can be used to sit upright or flat. You can also tilt your back at a 45-degree angle and elevate your legs.
These zero-gravity chairs are powered by two motors, and they are usually the most expensive option of all three. These chairs are the most versatile of all the lift chairs.
How Long Do Chair Lifts Last
While the chair itself will last indefinitely, the motor typically lasts between 10 to 20 years depending on how often it is used and if there are any adverse environmental factors, such as high humidity or damage to electrical equipment.
Hopefully, you or your loved ones wont be in a position where a mobility chair becomes a necessity.
If the situation does arise, enrollment in Medicare can help you or your loved one find the right chair to help with your condition and make life comfortable AND affordable.
Now that you know does Medicare cover lift chairs for the elderly, you can rest assured that an affordable chair is out there to lift your spirits.
Should Medicare give more benefits to the elderly aside from lift chairs? Let us know your thoughts down below!
About Haley Burress
Haley has been working with seniors and their caregivers for more than 17 years. She has held local and national leadership roles in a variety of senior services and senior care agencies. Today, she is a sought after writer specializing in topics for older adults, their family members, and professional caregivers. When she isn’t at her computer sipping coffee, you can find her hiking with her husband, son, and dog or trying a new cookie recipe in the kitchen. Follow her on . Read her LATEST POSTS. Learn more about her HERE.
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Where To Get An Approved Lift Chair
You can get an approved lift chair by searching through the Medicare Supplier Directory, which has information about suppliers who provide durable medical equipment in the U.S. Enter your ZIP code and choose patient lifts to find an approved supplier in your area.
Suppliers must satisfy strict qualifying standards to get a Medicare supplier number. Some questions to ask when choosing a supplier may include:
- Do you have a Medicare supplier number?
- Do you accept Medicare assignment?
- Will you bill Medicare for me?
Anyone who carries Medicare Part B can get a lift chair as long as its a medical necessity. Medicare Advantage plans may also cover lift chairs, but you must call your plans primary care provider to get DME coverage.
Repair and maintenance requirements for durable medical equipment also vary depending on whether you own or rent the equipment. If you own the DME, your supplier has no obligation to offer repair services. However, your supplier must repair and maintain the equipment if youre renting it.
Medical Standards For Lift Chair Coverage
There are some requirements that need to be met in order to get lift chair coverage. Here is a shortlist of those standards that make it medically necessary for you to have your lift chair covered by Medicare:
- Diagnosed with severe arthritis in the knee or hips
- Have a condition that makes it necessary to have lift chair support
- Cant stand up on your own from a regular chair
- Without the Lift chair, you would be confined to a chair or bed
- You must be able to operate the lift chair independently
- You can walk up once the chair is in the lifted position
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Medicare Covers Some Lift Chair Related Costs
Medicare Part B and Medicare Advantage will usually cover most of the costs of a lift chair however, there are some exceptions to this. If a person has already received medicare support for a scooter, wheelchair or other motorized mobility aid, they wont be eligible to have a lift chair covered on medicare.
In addition, Medicare does not cover the cost of a chair that uses a spring-type device to lift the rider out. Nor does it cover the cost of fabrics, cushions or other accessories. This means in most cases Medicare covers 80% of the cost of the motorized device. The recipient is expected to cover the remaining 20% of that cost, plus the cost of any comfort-related accessories such as cushions.
Does Insurance Cover Lift Chairs What You Need To Know
We’ve already discussed private insurance that individuals may have through Medicare Plan B. However, we haven’t yet discussed whether private insurance may cover the cost of this important mobility device.
If you have a private insurance policy through an employer or self-funded account, it’s important to discuss your coverage with your agent. Alternatively, you can call your insurance company directly to find out what mobility assistance devices your policy may cover.
In certain circumstances, private insurance companies may pay to rent or buy a lift chair. Some only partially cover lift chairs while others fully cover them. Still others don’t cover the cost at all. So, this really is a case-by-case basis.
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What Lift Chair Costs Are Covered By Medicare
If you qualify to receive coverage for a chair, the only component that will actually be covered as a medical necessity is the mechanical lift.
The expense of the chair will not be covered, since the lift can be configured and incorporated with a pre-existing reclining chair.
Additional expenses will include the cushions, fabric, and any massage pads that would be necessary to make the chair comfortable.
As with all qualifying expenses, Medicare will cover 80% of the cost, with the patients deductible and out-of-pocket expenses covering the rest. Depending on ones location, a mechanical lift will cost approximately $300 dollars.
That helps but is still expensive for some, so how do I get medicare reimbursement for a lift chair?
Does Medicare Cover Power Lift Chairs
- Jim Miller | Savvy Senior
Dear Savvy Senior, Because of back pain and knee arthritis Im interested in getting a power lift recliner for my living room thats easy for me to get into and out of. Does Medicare cover them? Cant Get Up
Dear Cant, Yes, Medicare does indeed provide some coverage for lift chairs, provided your doctor prescribes it for a medical reason, but it wont cover the entire cost of the chair. Medicare only will pay for the motorized lifting mechanism, which is considered durable medical equipment and is covered under Part B. The other parts of the chair the frame, cushioning and upholstery are not covered. Here are a few more details you should know.
What Is a Lift Chair?
First, for those who arent familiar with them, lift chairs, which look like traditional recliners, have motorized lift mechanisms built in that aid with standing up and sitting down for people with limited mobility. With the push of a button, a lift chair hoists a person from sitting to a position where they can comfortably stand up. It also works in reverse to help a person gently take a sitting position.
Medicare Coverage Requirements
If youre a Medicare beneficiary, to find out if you qualify for coverage, youll need to get a prescription and a Certificate of Medical Necessity from your doctor that indicates your need for a lift chair. The conditions youll need to meet include:
That you have severe arthritis of the hip or knee or a severe neuromuscular disease.
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Qualifying For A Medicare
Prior to 1986, Medicare coverage for lift chairs was restricted to patients suffering from muscular dystrophy, severe arthritis of the knee or hip, or other neuromuscular diseases. In 1986, the Health Care Financing Administration amended its policy to cover lift chairs based on medical necessity instead of diagnostic categories.
The requirements to qualify as a medical necessity are as follows:
- A physician must determine you can benefit therapeutically from its use.
- The lift chair is part of the doctors course of treatment and will likely support the improvement or slow down the deterioration of your condition.
- The condition is so severe that the only alternative is confinement in bed or a chair.
Both your doctor and lift chair supplier must be accepted by Medicare. Otherwise, Medicare wont pay your submitted claim. Medicare-participating suppliers can only charge you the coinsurance and Part B deductible for the DME-approved amount.
Theres no limit to the amount you can pay for durable medical equipment provided by a non-participating supplier. So make sure your doctor and supplier are accepted in Medicare.
Medicare Part B Costs
Medicare Part B is the portion of Medicare that pays for the lifting mechanism of the lift chair. With Part B, youll first need to meet your deductible, which is $203 in 2021.
Once youve met the deductible, youll pay 20 percent of the Medicare-approved amount for the lift mechanism. You will also pay 100 percent of the remaining cost of the chair.
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How Does Medicare Cover Lift Chairs
First, your doctor must fill out a form that declares a lift chair medically necessary for your treatment. Medically necessary in this case is a complicated way of saying you need it, a doctor can vouch for that need, and the equipment meets Medicares standards.
When you see your doctor, they will need to fill out a certificate of medical necessity and then submit it to Medicare .
To determine if your mobility is limited enough to qualify a lift chair as medically necessary, your doctor will need to answer the following questions on the form:
If you receive approval, Medicare covers up to 80% of the cost of the machine that lifts the chair. However, the cushions and framework of the chair itself aren’t covered. The motor and gear required to lift the chair are covered.2
Are You Affected By Medicares Competitive Bidding Program
If youre planning to use Medicare to offset the cost of a lift chair, you should be aware that the Medicare Competitive Bidding program may apply to your purchase.
It changes the amount of money Medicare pays for DME items according to location. Through this program, suppliers submit bids for DMEs and Medicare then uses these bids to set the amount theyre willing to pay for each item. There is some proof through longitudinal studies that show that this sometimes works in your favor because the competition drives prices of medical equipment down.
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Charities That Provide Free Lift Chairs
The Triumph Foundation exchange is intended to connect people who need adapted equipment and supplies with persons who have unwanted durable medical goods to offer. The things are absolutely free and have been donated in the hopes that they will find a good home.
Used Home Medical Equipment is a website that offers a free listing service for those with disabilities who want to buy, sell, or donate new and used home medical equipment. Mobility scooters, hospital beds, powerchair lifts, portable lifts, living aids, and other items are among those featured. Everyone can use the website because it is zip code-driven.
ECNV keeps a database of items that members of our community want to donate, and then connects those items to people who need them for free.
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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