How To Qualify For A Medicare Lift Chair
You will need to be evaluated by a doctor who will write you a prescription for the chair.
Your doctor must determine that the power lift chair is medically necessary and that without it, you would likely be confined to a bed or chair.
Lift chairs are usually prescribed to assist patients with severe arthritis, muscular dystrophy or other neuromuscular diseases.
The form contains several questions about your condition that will determine your Medicare eligibility.
To qualify for partial reimbursement from Medicare, you generally must meet the following requirements:
- You have severe arthritis of the hip or knee or a severe neuromuscular disease.
- You cant stand up on your own from a regular chair.
- Without the lift chair, youd be confined to a bed or chair.
- Once standing, you can walk independently, even if you need the assistance of a walker or cane.
- You do not live in a skilled nursing facility, hospice or nursing home.
If you purchase your lift chair from a Medicare supplier, youll typically have to pay out-of-pocket for the chair and seek partial reimbursement from Medicare for the motor.
If the equipment supplier participates in Medicare, it will usually file a claim on your behalf. If the supplier doesnt file your claim, you can online.
After the claim is processed, youll be reimbursed for the portion covered by Medicare.
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How To Get Your Lift Chair Covered
For Medicare to cover your lift chair, your doctor or treating physician must prescribe it by filling out an order stating that the equipment is medically necessary. Your doctor typically fills out a Certificate of Medical Necessity, which has questions aimed at demonstrating your medical need for the equipment.
Your supplier follows up with your doctor to ensure the form is submitted to either Medicare or your Medicare Advantage provider. Your doctor must complete and submit a new, updated order should your condition or needs change in the future.
Medicare will only cover lift chairs obtained from a Medicare-accepted supplier. Suppliers must be approved by Medicare and have a Medicare supplier number.
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Some Programs And Waivers Offer Greater Breadth In Their Interpretation Of Dme Covered For Care In The Home
Two types of state programs which allow for a wider interpretation of what durable medical equipment coverage are
HCBS programs and waivers which employ a system of beneficiary budget management called either Consumer DirectionorSelf Direction.
To find out more about Medicaid Self Direction click here.
The Medicaid program Money Follows The Person
Medicaid set up this program to help elderly adults transition from living in nursing homes, back to their own homes.
And it now supports individual states by funding them, to either build a new Money Follows The Person program in their state, or to modify an existing program in their state.
Programs will pay for the items and modifications, which are necessary for the participants to be able to live safely, and independently, in their own homes again.
Remodeling parts of the home to make things safer and easier, improved lighting, building ramps etc., or just providing the basic DME, are all part of and paid for by the program.
Will Medicare Pay For A Lift Chair
People who need help getting in and out of their chair daily due to life changes such as aging, arthritis, or a recent mobility-limiting surgery, often consider buying a lift chair. However, lift chairs can cost hundreds or even thousands of dollars, leaving many Medicare beneficiaries wondering if their Medicare health insurance coverage will help pay any of the lift chairs costs. While Medicare typically wont 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 its medically necessary and will help your condition. Read on to learn more about Medicare coverage of lift chairs.
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Medicare Advantage Plans Help Pay For Lift Chairs
You have options when it comes to your Medicare coverage. Depending on where you live, you may be able to enroll in a Medicare Advantage plan.
If your lift chair would be covered by Medicare Part B, it is also covered by Medicare Advantage plans .
Medicare Advantage plans provide the same hospital and medical benefits as Original Medicare, and some plans may offer benefits that arent included with Original Medicare, such as coverage for prescription drugs, vision and dental care.
To learn more about Medicare Advantage plans and to find plans in your area, call a licensed insurance agent today or compare plans online.
Explore Medicare Advantage plan benefits in your area
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About the author
Christian Worstell is a licensed insurance agent and a Senior Staff Writer for MedicareAdvantage.com. He is passionate about helping people navigate the complexities of Medicare and understand their coverage options.
His work has been featured in outlets such as Vox, MSN, and The Washington Post, and he is a frequent contributor to health care and finance blogs.
Christian is a graduate of Shippensburg University with a bachelors degree in journalism. He currently lives in Raleigh, NC.
Where you’ve seen coverage of Christian’s research and reports:
Medicare has neither reviewed nor endorsed this information.
How Do I Get Medicare To Pay For A Hoyer Lift
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.
One may also ask, are ceiling lifts covered by Medicare? Yes, Medicare covers ceiling lifts under Medicare Part B as durable medical equipment.
Also to know is, does Medicare pay for bed lifts?
Payment. Medicare Part B covers a patient lift if the person cannot move from a bed to a chair, wheelchair or commode without the help of more than one person the patient would be confined to a bed without the use of a lift. An order must be on file with the supplier.
How much does it cost to rent a Hoyer lift?
The weekly rate for a Power Hoyer Lift is $125 and monthly rate is $195 with a $350 refundable security deposit.
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Get A Free Medicare Quote Today
Working with a local Medicare expert means you no longer have to wonder: Will Medicare pay for a lift chair or Does Medicare pay for a hospital bed?
Weve made it easy to be connected with a local, independent Medicare insurance agent and get a free Medicare quote. Get started today and receive the benefits that you deserve and need to be your best, healthy self.
Learn more about your Medicare options from a local Medicare pro today! Click the button below to get a free Medicare quote.
Canvas Or Nylon Sling Or Seat
Aetna considers a canvas or nylon sling or seat for a hydraulic/mechanical lift medically necessary as an accessory when ordered as a replacement for the original equipment item. Note: A nylon or canvas sling or seat for a patient lift is included in the allowance for a patient lift when provided at the same time.
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Dont Confuse Bathroom Lifts With Patient Lifts
Dont confuse bathroom lifts, such as bath lifts and toilet lifts, with patient lifts.
Patient lifts are for disabled individuals who cannot even get out of bed on their own, whereas bath lifts and toilet lifts are for those who have issues with mobility, but who can still walk, even if it is with the aid of some kind of device.
Bath lifts and toilet lifts are not covered by Original Medicare Part B, as they are considered to be convenience devices and not primarily medical in nature.
You can find the coverage determination for all the devices at CMS.gov Center for Medicare and Medicaid Services in the National Coverage Determination for Durable Medical Equipment Reference List , which you can read .
Does Medicare Cover Lift Chairs
Lift chairs come under the category seat lifts for Original Medicare.
Only mechanical/hydraulic seat lifts may be considered if all the criteria are met.
Original Medicare Part B only partially covers lift chairs they will typically give 80% coverage for the mechanical part of a lift chair for use in the home, and only when it has been prescribed as medically necessary by a Medicare-enrolled physician.
The Medicare guidelines for coverage for a seat lift mechanism are the following
Indications and Limitations of Coverage
Reimbursement may be made for the rental or purchase of a medically necessary seat lift when prescribed by a physician for a patient with severe arthritis of the hip or knee and patients with muscular dystrophy or other neuromuscular diseases when it has been determined the patient can benefit therapeutically from use of the device. In establishing medical necessity for the seat lift, the evidence must show that the item is included in the physicians course of treatment, that it is likely to effect improvement, or arrest or retard deterioration in the patients condition, and the severity of the condition is such that the alternative would be bed or chair confinement.
Source: National Coverage Determination for Seat Lift which you can find here.
More simply, the criteria for coverage for a Seat Lift are
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Weight Capacity: Standard Or Bariatric
The weight capacity of a ceiling lift is an important consideration, and each ceiling lift has its own specific weight capacity.
Most lifts are capable of supporting between 300 and 450 pounds. If the user exceeds this weight threshold, there are bariatric ceiling lifts intended for patients who exceed these weight limits.
Because no two patients are exactly the same, the weight capacity of a ceiling lift can be a crucial consideration when looking at ceiling lifts.
Do Medicare Supplement Plans Cover Lift Chairs
Medicare Supplement Insurance plans, also called Medigap, do not cover lift chairs themselves.
Medigap plans, however, do help cover the 20 percent Medicare Part B coinsurance charges that are required for a lift chair, after you meet your Medicare Part B deductible.
Learn more about Medicare Supplement Insurance .
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How To Get Coverage From Medicare Part B For Dme
Coverage from Original Medicare Part B for durable medical equipment for use in the home is given only if
- you are enrolled in Medicare Part B
- you have your Medicare-enrolled doctor sign a prescription certifying that the equipment is a medically necessary
- you purchase, or rent, the DME through a Medicare-enrolled supplier
State Financial Assistance Programs
In the US there are also, in a number of states, non-Medicaid state programs which are designed to assist the elderly and the disabled financially to maintain their independence in their own homes these are usually known as State Financial Assistance Programs.
State Financial Assistance Programs can cover quite a range of assistive devices, safety equipment and home modifications, to help the elderly beneficiary maintain their independence, and they can do this by giving grants or loans, or a combination of the two.
To get more information on whether your state has a State Financial Assistance Program contact your local Area Agency on Aging you can locate one near you here.
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Do Medicare Advantage Plans Cover Patient Lifts
Medicare Advantage plans are provided by companies contracted by Medicare to give all the Medicare services, and to cover everything that Original Medicare Parts A and B cover, and that includes patient lifts if you qualify under the Medicare guidelines.
As of the last quarter in 2020, Advantage plans will be allowed to extend the number of extra benefits they offer.
With regard to how to get coverage and where to get equipment, that depends on who your provider is, and you will need to ask them about suppliers and the procedure.
Hoyer By Joerns Healthcare
Most Industry Experience
The original Hoyer brand lift was designed by the quadriplegic Ted Hoyer and his associate Victor R Hildemann. This lift design, which may have been based on the earlier concept of an engine lift, was patented in 1958. The patient lift became so useful that the Hoyer name grew to be more recognizable than the generic term adjustable base invalid lift which Hoyer originally filed the patent application under. This innovative brand is still well known, and its lifts are now manufactured and distributed by the respected medical equipment brand Joerns Healthcare.
Customers who are looking for a lift brand with a thoroughly proven track record will find Hoyer by Joerns an excellent option. Joerns brings over 125 years of industry experience to the already impressive history of the Hoyer lift. The company, which is headquartered in Charlotte, North Carolina, is trusted throughout North America and Europe to provide a diverse range of high-quality medical equipment to institutions and retailers.
Overview of Hoyer by Joerns Healthcare
Pros and Cons of Purchasing Lifts from Hoyer by Joerns Healthcare
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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
Are Sit To Stand Lifts Covered By Medicare
A sit to stand lift is similar to a lift chair but can assist a person with transitioning from a seated to standing position from chairs, beds, commodes or other items.
These are classified as a type of patient lift and are covered by Medicare Part B and Medicare Advantage plans as durable medical equipment in the same way that lift chairs are covered.
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Molift Smart 150 Patient Lift
The portability of the Molift Smart 150 Patient Lift, made by R82, is the main reason our number 4 entry is one of the best on the market. Without tools, this patient lift can be taken apart into two pieces for transport. It comes with its own travel case, and is even approved by the TSA for air travel.
Its compact design means it can be maneuvered in even the most confining areas. It doesnt need to be taken apart to be stored, since its foldable frame makes it easy to stow under a bed or in a closet when not in use. Even with its portability, it has a wide lifting range from the floor, and its 4-point sling bar ensures correct patient posture during transfers. The legs on this electric patient lift are manually adjustable.
Powerful enough to lift a patient up to 330 pounds from the floor if necessary, the Molift sling options provide safety and comfort for the user during transfers, and it requires no lifting or pulling by the caregiver.
This electric lift comes with a charger and a rechargeable battery that holds a 3-hour charge. It will let you know when it needs maintenance, and its built-in lifting counter monitors daily, weekly, monthly, and yearly lifting patterns for service techs to retrieve during diagnostics and annual inspections. it has manual lowering functions and a safety stop feature in case of an emergency or a disruption of power.
Will Medicare Pay For A Stair Lift
Original Medicare Part B does not cover stair lifts, as they are classed as electric seat lifts which are classified as a convenience, and are not considered durable medical equipment, or as medically necessary.
You can find the coverage determination in the National Coverage Determination for Durable Medical Equipment Reference List which you can read .
Some Medicare Advantage plans may soon cover stair lifts as an extra benefit they will be allowed to offer as part of the new policies for individuals with chronic illnesses and diseases.
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Purchasing Vs Renting Durable Medical Equipment Through Medicare
Durable Medical Equipment can end up being quite expensive. You may find equipment available for purchase or rental. In most cases, Medicare pays to rent medical equipment. But Medicare will buy some equipment thats inexpensive like a walker or cane.
Medicare usually will help with any repairs or replacements you may need for your device. Sometimes you need the equipment longer than a few months. Medicare may buy equipment rather than renting for situations like these.
Health Care In The Home Medicaid And State Programs
The programs aimed specifically at low income families, the disabled and the elderly for in the home care, and designed to help the beneficiary maintain their independence are calledHome and Community Based Services , Waivers or 1915 Waivers.
To help with the maintaining of independence in the home, the programs and waivers, offer assistance withhome medical equipment DME and often cover as much as 100% of the cost.
You can check your eligibility for any programs by contacting your State Medicaid Agency here.
If you want more in depth information on HCBS programs, or waivers, you can go here on Medicare.gov
These programs use the term home to mean the following
To find out more about Medicaid Self Direction click here.
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