Wednesday, May 8, 2024

Will Medicare Pay For A New Mattress

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Can You Obtain A Prescription For A Flexible Bed

Does Medicare pays for hospital beds?

For an individual to be qualified for a flexible bed that certifies as DME, their medical professional should compose a prescription mentioning that the bed is clinically required According to the qualification demands, the bed is a clinical need if an individual requires: placing to soothe discomfort or advertise body placement.

Beds Are Durable Medical Equipment

Specific types of beds are considered Durable Medical Equipment under Medicare.

Durable Medical Equipment is equipment that assists patients in their day-to-day lives. Its a kind of health equipment that your doctor considers medically necessary like wheelchairs, walkers, oxygen equipment, etc.

Only your physician can prescribe DME for you, and you must meet specific criteria if you want Medicare to cover the cost:

  • It must be used for a medical condition.
  • It must be durable and long-lasting.
  • You can use it at home.
  • It is not effective for someone who isnt sick or limited by injury.
  • It will last for at least three years.

Luckily, if youve been prescribed a piece of DME that fulfills these conditions, Medicare will cover up to 80 percent of the cost of the equipment. The new mattress might fall under the Durable Medical Equipment category if you buy a specific Medicare-approved type.

What Kind Of Mattresses And Beds Are Covered

There are a few types of mattresses and beds covered by Medicare. If you are a Medicare subscriber, then it’s important to understand the guidelines and what qualifies to be covered. Essentially, you’ll need to make sure the mattress is classified as durable medical equipmentâsometimes referred to as “DME.”

For a mattress to be given a designation as durable medical equipment, it must be an essential part of a patient’s normal life. This designation can only be obtained from a doctor after they determine your bed is medically necessary. In addition to a DME classification, it must also meet 5 additional criteria.

These 5 criteria are:

  • Capable of handling repeated use
  • Only useful to a sick or injured person
  • Must be used at home
  • Must have a minimum life expectancy of 3 years
  • To summarize, if your mattress meets the following three criteria, Medicare covers the cost of up to 80% of the mattress price.

    • DME Classification

    Typically, the only types of mattresses that meet these specifications are pressure-reducing mattresses.

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    What Is The Purpose Of The Adjustable Bed

    What are the different types of hospital beds available? Whether or not you get Medicare to pay for it, there are four types.

    A manual hospital bed is adjusted by turning a crank. A variable height hospital bed is a manual bed with adjustable height. The semi-electric hospital bed allows for the adjustment of the head and foot sections of the bed. For this type as well, a manual crank can adjust the height of the bed. Finally, there is the bariatric or heavy-duty hospital bed which is made for heavy individuals.

    Now, lets move on to whether or not Medicare will help you pay for the type of hospital bed you choose.

    Will Medicare Cover The Adjustable Bed

    Are Adjustable Beds Covered by Medicare?

    First, the good news. Medicare Part B will cover the adjustable bed. Now, there is a catch. Both your doctor and the company that actually supplies the bed must be enrolled with Medicare as a health care provider to fit the coverage criteria.

    Do you need to own the bed forever? According to, If you need it on a short-term basis you may very well be able to just rent it.

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    How To Get A Medicare

    Orthopedic mattress coverage is not available to everyone with Medicare coverage. You’ll want to make sure the mattress is designated as durable medical equipment . It must be an important part of a patient’s needs in order to be classified as durable medical equipment.

    To have an Orthopedic mattress covered by Medicare, get a prescription from a physician, submit this to Medicare, and obtain the mattress from a Medicare-approved supplier.

    Only a doctor can determine and confirm that an orthopedic mattress is medically required. It must also meet five additional criteria in addition to the DME certification: 1) it is only used for medical purposes, 2) it can withstand frequent use, 3) only a sick or injured person would find this useful, 4) it will be used at home, 5) and a three-year minimum useful life expectancy is required.

    An orthopedic mattress that is covered by Medicare must only be used by the patient for medical reasons. Image Source: .

    You might also find interest in learning how to find an orthopedic mattress for scoliosis. Be sure to take a look at our related article to find out more. Also, if you ever wondered what the difference is between an orthopedic mattress vs. a regular mattress, be sure to read that one too.

    Here we explain the steps to having your orthopedic mattress covered by Medicare:

    Your Mattress Must Qualify As Durable Medical Equipment

    Medicare has certain guidelines that must be met if you want the program to cover the cost of your mattress. The most important thing to know is that the mattress needs to qualify as Durable Medical Equipment .

    Durable medical equipment is equipment used to help patients function in their everyday lives. These items are deemed medically necessary by your doctors and can include things like wheelchairs, walkers, oxygen equipment and more.

    Not everyone qualifies for DME, and it can only be prescribed . Along with a prescription, here are the five mandatory criteria that needs to be met for Medicare coverage:

    • It must be used for medical purposes
    • It needs to be durable and meant for repeated use
    • It is not useful to someone who isnt sick or injured
    • You can use it at home
    • The items general life expectancy should be at least three years

    Medicare will cover up to 80 percent of the durable medical equipment after your claim is approved. Mattresses do fall under this category, but only if the patient purchases a certain type approved by Medicare.

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    Is Adjustable Bed Worth The Money

    While the term adjustable bed refers to a base that can tilt your mattress to create various sleeping positions, the mattress can be considered separate. If you can afford an adjustable bed, but will then be priced out of a comfortable and high-quality mattress, an adjustable bed may not be worth the investment.

    Will Insurance Pay For A Tempur

    Medicare : Will Medicare Pay for a Craftmatic Bed?

    For people with back or spinal injuries, a Tempur-Pedic mattress is a great choice. A Tempur-Pedic mattress is designed for spinal alignment and pressure relief. It has the ability to contour to the shape of the body, keep the spine and neck aligned, and help prevent the build-up of pressure points on the back and joints. Hence, it can be medically prescribed for patients with back and spinal injuries.

    Medicare, Medicaid, Aetna, BCBS insurances will cover a Tempur-Pedic bed. In order for the bed to be covered, a physician must supply evidence of spinal injuries, back injuries, or any other medical condition that justifies a Tempur-Pedic bed. United Healthcare and CIGNA will not cover a Tempur-Pedic bed.

    This type of bed is expensive, therefore, being covered by insurance can help many patients afford it. Read our article about tips for choosing an orthopedic mattress for sciatica pain to help you choose the correct pressure-relieving mattress.

    Not all health insurances cover Tempur-Pedic beds like these. If your doctor has prescribed a special type of mattress for your medical condition, Medicare insurance can cover that for you as long as you have the necessary documents from your doctor recommending that mattress. Medicaid also covers DME including beds or mattresses for medical purposes, as long as they are considered necessary by a physician. However, this is not the case with private health insurance companies, as they do not all cover Tempur-Pedic mattresses.

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    What Do I Need In Order To Get A Hospital Bed On Medicaid

    Weve mentioned what requirements a product needs to meet in order to be categorized as DME, but what do seniors need to be to be approved for a hospital bed on Medicaid?

    First and foremost, you must be a Medicaid patient. If you are not already enrolled in Medicaid, head here to apply in your state.

    Second, you must demonstrate a true medical need for the bed. For example, if you are bedridden and your condition requires a reclining/sleeping posture that a normal bed cannot replicate, and you are going to be in this condition for at least 30 days, you will most likely be approved.

    How do you know you truly need a hospital bed? This can be determined while you fulfill the next requirement for getting a hospital bed: a doctors prescription.

    You must obtain a prescription from a doctor who evaluates your condition and determines that you do in fact need the hospital bed. Sometimes, this happens as part of your normal treatment and discharge at a hospital. In other cases, however, youll have to schedule a doctors visit and make your case.

    Once you get your prescription, you are qualified for a hospital bed and can begin the process of applying for and choosing your bed!

    Which Types Of Beds Are Covered By Medicare

    Only certain mattresses qualify as durable medical equipment. The mattress must serve a medical purpose³ thats recommended by your doctor. Its important to know which mattresses qualify under Medicare so you know if the mattress you need will be covered.

    There are the three types of beds and bed-related equipment covered by Medicare:

  • Pressure-reducing beds
  • Pressure-reducing mattresses
  • Pressure-reducing mattress overlays
  • Its always cheaper to purchase your mattress with a Medicare supplier. To find suppliers, youll want to search online to find Medicare-approved mattress and bed suppliers in your area. There are a lot of options out there, so make sure to focus on the ones approved by Medicare so you know it can qualify for coverage.

    Typically, Medicare will pay 80 percent of the cost and subscribers will pay the remaining 20 percent. Mattresses can be expensive, so this is a huge savings opportunity Medicare insured patients should take advantage of.

    Look into your health plan or talk to a Medicare representative that can guide you through your coverage. The costs can vary depending on your plan, so its good to research what you qualify for before spending any money.

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    How Often Will Medicare Replace A Mattress

    If your equipment is worn out, Medicare will only replace it if you have had the item in your possession for its whole lifetime. An items lifetime depends on the type of equipment but, in the context of getting a replacement, it is never less than five years from the date that you began using the equipment.

    Just How Much Does It Set You Back To Rent Out A Hospital Bed For House Usage

    Are Adjustable Beds Covered by Medicare?

    Leasing House Hospital Beds Generally, it sets you back one $200 $500/ month to rent out a residencehospital bed One can likewise locate cushions for rental fee. Some firms that rent out house hospital beds might bill a first charge for set up. If this holds true, one ought to anticipate to pay an added $50 to $100.

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    Is Sleeping On An Adjustable Bed Good For You

    Like snoring, sleep apnea and asthma are breathing problems that can be decreased by simply using the adjustable bed frame to raise the head. Sleeping in a more angled position improves airflow, reducing obstructions from the nasal passages to allow for a healthier, uninterrupted sleep, caused by apnea.

    What Is Durable Medical Equipment

    Durable medical equipment is any equipment or supplies that you need for your health. describes durable medical equipment as medically necessary and prescribed by a doctor for use in your home.

    Commonly, there are two kinds of medical equipment that youll use at home: durable medical equipment and disposable medical supplies. While disposable medical supplies are typically used once, then thrown away, durable medical equipment is the opposite. Its medical supplies that are meant to last you a long time.

    In order to be Medicare-eligible durable medical equipment, an item must meet these requirements:

    • Primarily serve a medical purpose.
    • Be prescribed or ordered by a medical professional.
    • Be able to be used repeatedly .
    • Able to be used at home.
    • Is only useful to a patient with an injury, medical condition, or disability.

    DME often helps Medicare subscribers manage their health needs better. Because this kind of equipment is meant to be used long-term for health benefits, its needed to manage many medical conditions and illnesses. Items like blood sugar monitors, oxygen equipment, and walkers and wheelchairs all qualify as pieces of DME.

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    Does Medicare Cover Hospital Beds

    Has your doctor recommended that you have a hospital bed in your home to assist with your medical condition? If you are a Medicare beneficiary enrolled in Original Medicare , your Part B benefits may cover 80% of the allowable charges for hospital beds after you meet your Part B deductible, as long as both your health care provider and medical equipment supplier participate in the Medicare program.

    Find affordable Medicare plans in your area

    Does Medicare Cover Adjustable Beds

    Medicare : Will Medicare Pay for Adjustable Beds?

    Medicare covers adjustable beds under Part B.

    Medicare Part B pays for outpatient medical costs, such as durable medical equipment. This includes adjustable beds. Part B will cover these beds when your doctor orders one for you to use in your home.

    For Part B to cover your adjustable bed, both your doctor and the company thatll supply the bed must be enrolled as Medicare providers.

    Depending on the bed you need and the supplier, you might be able to:

    • rent the bed

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    • Its likely that Medicare Part B will cover an adjustable bed.
    • Your doctor and the provider of the adjustable bed must be covered under Medicare.
    • If you only need the bed on a short-term basis you may very able to rent it.

    If youre here today youre probably trying to figure out if Medicare covers adjustable bed costs. Medicare can be complex, so well go through whether or not Medicare will cover an adjustable bed step by step. If youd like to learn more about how much you could be paying for services with Medicare in general, read our article What is the maximum out-of-pocket expense with Medicare?

    Before you buy health insurance, type your ZIP code into our free and helpful tool above to find affordable health insurance rates in your area.

  • Medicare Parts A and B
  • Final Thoughts: Medicare And Mattresses

    In summary, you can receive Medicare coverage for your equipment if it is what your doctor says you need. But, you also must purchase from a Medicare-approved supplier.

    Its also important to keep in mind that there are restrictions on the types of mattresses Medicare covers. Electronic beds and some other equipment will not be covered, and other features may reduce coverage. Because mattresses are DME, Original Medicare will cover them.


    Do you have questions related to Medicare coverage? Give us a call anytime at . We are licensed nationally and work with all of the top insurance companies.

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    Are Adjustable Beds Good For Seniors

    Adjustable beds are a valuable investment for different kinds of sleepers. However, they are most beneficial for seniors who suffer from different chronic conditions as well as therapeutic injuries. Those beds can mostly be found in hospitals, but many manufacturers make them for in-house usage too.

    Can A Medigap Plan Help

    Will Medicare Pay for Adjustable Beds?

    Yes, it can. You can use Medigap plans to cover fees that Medicare usually leaves as out-of-pocket expenses. If you need extra help with these fees, then many Medigap plans end up being good to buy.

    When you need to use a mattress under Medicare coverage, your deductible will apply. After this, you will have to pay a coinsurance. Every Medigap plan except for Plan K and Plan L covers the Part B coinsurance. But, Plan K still covers 50% of your coinsurance, and Plan L covers 75%.

    Only Plan F covers the Part B deductible. Plan F is not available for people who become eligible for Medicare in 2020. If you cannot buy Plan F, then you must pay your deductible. Although Plan F isnt as available, people who already have it can still use it. If you became eligible for Medicare before 2020, you can still use Plan F even if you only chose to do so after 2020 began.

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    Medicare Parts A And B

    What is Medicare Part B? Part B provides outpatient/medical coverage. You would be using this type of equipment, or adjustable bed, in your own home, hence it being covered by the outpatient portion.

    Lets take a look at the rates for Part B, which is really the part youll need before we learn what the other parts will do for you.

    Medicare Part B Estimated Monthly Premiums, Deductibles, and Coinsurance Rates


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