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.
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 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.
How Much Will It Cost After Medicares Involvement
As mentioned earlier, once approved, Medicare will take 80% of the cost. In many cases, the patient purchases the lift chair and submits the cost of acquiring it to his/her provider. The provider, in turn, submits it to Medicare for proper documentation. Medicare then reimburses the patient to the tune of about $250-$300. The remaining cost will be handled by the patient.
Does Medicaid Cover Lift Chairs
Medicaid is funded federally and by the individual states, because of this it will often agree to waive certain requirements for eligibility for different programs.
Such programs for which Medicaid agrees to waive requirements are called waivers.
These waivers are designed to assist different groups, or demographic, which might otherwise be missing out on healthcare across the US there are many waivers which are specifically for the elderly, and for helping them to remain living safely in their own homes, and which offer financial assistance with DME and health care.
You can check to see what your state offers below.
What Costs You Need To Cover
If Medicare approves coverage of your wheelchair, you still have a financial obligation to meet. Customary with any health insurance, you must meet your Part B deductible for that year, then cover 20% of the Medicare-approved amount. Usually, this approved amount wont exceed the actual charge or fee Medicare sets for the item.
Medicare will generally pay for the most basic level of equipment needed. If you need upgrades or extra features and your supplier thinks Medicare wont cover them, youll need to sign an Advance Beneficiary Notice before receiving the item. On this waiver form, you must check the box stating you wish the upgrades and will agree to cover their full cost if Medicare denies coverage.
You may have to cover the full cost of your wheelchair if you get it from a supplier that isnt a contract supplier.
Get A Free Medicare Quote
If youre over 65 and dealing with chronic pain, or youre having trouble moving around your house as well you used to, a lift chair may help improve your quality of life. These chairs feature powered lifting mechanisms that push them up from their base and assist their users with achieving a standing position.
Medicare offers some help when it comes to paying for lift chairs, but its important to understand the ins and outs of the federal governments policy before shopping for a chair or associated equipment. First off, youll need to be enrolled in Medicare Part B. Once that is done, youll need to select a chair or a chair provider. Here is where things get interesting. Medicare only covers the seat lift mechanism itself and not the entire chair. Medicare assigns every reimbursement-eligible product something that is called an allowable amount. This is the highest amount that Medicare will consider as the items total price. Medicare usually pays out 80% of the allowable amount, with the remaining 20% coming out of the pocket of the patient.
Does Medicare Cover Lift Chairs For The Elderly
- Does Medicare cover lift chairs for the elderly? Medicare does provide some coverage for lift chairs, provided a doctor prescribes it for a medical reason. However, Medicare does not cover the entire cost for the chair.
Stair lifts can cost thousands of dollars, and many seniors wonder if Medicare will help cover the cost. Medicares Part B includes coverage for durable medical equipment , such as wheelchairs, and walkers, but stair lifts are usually not included in these benefits.
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Working With Your Doctor For A Prescription
The first step in the process in getting a lift chair covered by insurance is to work with your doctor. Medicare requires a doctor’s prescription and a copy of your medical record explaining the need for the equipment.
A seat lift mechanism is covered if all of the following criteria are met:
We suggest scheduling an appointment with your doctor to discuss your concerns and the need for a lift chair. Weve put together a form for your doctor to fill out to make it easier to get the ball rolling and the conversation started. You can.
Once you have your doctors prescription and chart notes its time to get the information over to a DME provider that has been enrolled in Medicare. Medicare will only cover your DME if your doctors and DME suppliers are enrolled in Medicare. Doctors and suppliers have to meet strict standards to enroll and stay enrolled in Medicare. If your doctors or suppliers arent enrolled, Medicare wont pay the claims submitted by them.1
Changes To Medicare Advantage
Medicare Advantage Plans are like your HMO or PPO and give you extended coverage. As of 2019, changes to the provisions of these plans may group lift chairs as an allowable supplemental health care benefit.These changes make it easier than ever for those with a specific injury or physical and medical need to access lift chairs in a cost-effective way.
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Ship State Health Insurance Assistance Programs
For those who need help with understanding Medicare, Medicaid and Medigap, and I think thats most of us, the State Health Insurance Programs offer free counseling over the phone.
You just have to find your SHIP contact info, and you can do that hereFree Help Understanding Medicare And Medicaid ? Heres Where You Get It.
Generally Medicare Coverage Eligibility For Your Chair Lift Mechanism Will Include The Following:
- You have a condition that inhibits your mobility, like severe arthritis in your hip or knee or a neuromuscular disease like muscular dystrophy.
- Because of this condition, you are unable to stand up on your own and would otherwise be confined to a bed or wheelchair.
- Your doctor has determined that regular movement is medically necessary and has prescribed a lift chair as part of your treatment plan.
- You are able to control the seat lift yourself and the equipment helps you sit or stand up without other help.
Medicare typically wont pay for recline functions or seat lifts that use a spring-release mechanism.
If youre having mobility issues, BEK Medical is here for you. We have a variety of mobility products and other offerings that will make your life easier and more comfortable. Give us a call at to find out more.
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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.
Other Benefits Of Lift Chairs Covered By Medicaid
Many lift chairs covered by Medicaid offer a variety of other features and benefits to appeal to consumers. Whether Medicaid approves or denies your request for a lift chair, its important to consider the long-term benefits one gains from owning a lift chair. VivaLift!® Power Recliners, for example, offer the convenient stand assist that many people need. Yet, did you know that VivaLift! Power Lift Chairs have a lot of features that ensure greater comfort? The VivaLift! Escape Collection Lift Chair includes a full-width power headrest that can lift the neck, shoulders, and head. The convenient remote with a USB charger lets you power your cell phone or tablet while you relax. Choose from gorgeous fabrics and colors that are luxurious and match your style and decor.
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Does Medicaid Pay For A Lift Chair
Medicaid may cover a lift chair if a patient meets the requirements. If you qualify, Medicaid may cover the cost of a VivaLift! ® Infinity Power Recliner , or another lift chair . Medicaid isnt a federally run program and is managed by individual states, so its important to note that eligibility will vary by state.
By Step Guide To Medicare Coverage For Lift Chairs
The motorized portion of the lift chair is a Medicare covered item, so if you qualify, Medicare may cover up to 80% of the approved amount for the motor.You would be responsible for any co-pay or deductible amounts as well as the additional cost of the furniture portion of the chair. In order to determine if you qualify, you will need to follow these steps:
Obtain a prescription from your physician for the seat lift chair.You may need an in-person or face-to-face visit with your physician.
Your provider has a special form for your physician to fill out. You will need to take this form to your physician. It contains several questions about your condition that will help determine your Medicare coverage.In order to qualify for the seat lift mechanism under Medicare, there are a few things to keep in mind:
Once your provider obtains the appropriate medical information from your physician, you will next need to select your lift chair. Upon obtaining your lift chair, your provider will submit the claim to Medicare for you.
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How Do I Choose The Right Lift Chair
Whether you visit a dealer in person or online, be prepared to discuss your medical, household and lifestyle needs and preferences. A knowledgeable supplier can help you choose the right chair.
In addition to accommodating specific medical needs, you may want to consider the following factors when choosing a lift chair:
- Body type. For a chair to be comfortable and function optimally, it shouldnt be too big or too small, so select a chair thats designed for your height and weight. Remember: your feet need to touch the floor when the chair is in the lifted position.
- Space restrictions. Your chair should fit comfortably into your home. When shopping for a chair, bring the relevant measurements, including doorways the unit must fit through. Ask your supplier how much space your lift chair needs to fully function.
- Specific uses. Consider how you plan to use your chair. Will it just be used for watching TV or will you be sleeping in it regularly?
- Lift chairs come in a variety of fabrics. You should consider both aesthetics and functionality when choosing a type of upholstery.
- Optional therapeutic benefits. Some chairs offer additional features such as heat and massage features or cupholders.
How Do I Get Medicare Reimbursement For A Lift Chair
When you stand, you are able to walk. Download the CMS-849 Certificate of Medical Necessity form, 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.
Does Medicare pay for recliners?
Yes, Medicare Part B sees lift chair recliners as durable medical equipment and this means it covers them. However, they are only responsible for about 80% of the expenses, and you will have to be accountable for the other 20%.
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.
What Is Medically Necessary
A big portion of receiving Medicare coverage for medically durable equipment is that your doctor deems that this equipment is medically necessary for you to survive and treat your condition. These medically necessary services as defined by Medicare.gov are: Services or supplies that are needed to diagnose or treat your medical condition and that meet accepted standards of medical practice. In the case of a lift chair, this means it must be absolutely necessary to treat your condition . Your Medicare-approved doctor will have to prescribe the chair as a supply you need in order for it to be covered.
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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 to rent the DME through a Medicare-enrolled supplier
Lift Chair & Medicare
Are you a senior citizen who wants to know about Medicare and medical lift chairs? Seat lift chairs, what Medicare calls lift chairs, are covered under a range of items called Durable Medical Equipment which are apart of Medicare Party B.
If you have Medicare, Medicare can reimburse you for a purchase of a lift chair if you meet certain requirements. The reimbursement is never for the full cost of the chair as it only covers 80% of the cost of the lift mechanism . This part is also called a seat lift.
For DME, individuals on Medicare part B must buy their equipment from Competitive Bidding Suppliers if they live in a Competitive Bidding Zone. Luckily for lift chair buyers, seat lift mechanisms are in the Non-Competitive Bid category. This means that individuals can buy lift chairs from any supplier, online or offline, and receive a rebate, regardless if they live in a Competitive Bidding Area or not.
This article will help you understand Medicare guidelines, requirements, billing, and coverage for power lift chairs.
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How To Find A Lift Chair Supplier
Your physician will doubtless be able to point you in the right direction for equipment suppliers who are approved by Medicare.
But you can also find out by simply clicking here to go to the Medicare.gov website to use their Medicare-enrolled supplier locator.
Just enter your zip code, and you will get a list of suppliers in your area that you can see on the screenshot of their web page below.
How Much Does Medicare Pay Towards A Lift Chair
If you qualify, lift chairs Medicare coverage is typically 80% of the allowable charges for the motorized lift portion of the chair only, even if the lift device is built into the chair itself. You generally pay 20% of allowable charges, plus any outstanding Part B deductible.
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Are There Situations Where I May Be Denied Coverage For A Lift Chair
Even if you qualify based on the questions above, Medicare may still deny you a lift chair if it has already covered the following items for you:
- A manual wheelchair
- A power wheelchair
- A mobility scooter
However, even if Medicare has covered one of these items for you, as long as your health has improved to the point that you can walk again, you might also receive Medicare coverage for a lift chair.
Additionally, if you are currently in a hospital or skilled nursing facility, Medicare coverage for a lift chair is more likely to be denied.