Does Medicare Cover Hospital Beds?
If you're in need of a hospital bed for yourself or a loved one, you may have questions about Medicare coverage. While Medicare does provide coverage for basic hospital beds for eligible patients, there are specific conditions that must be met.
Requirements for a Medicare-approved hospital bed:
To qualify for a hospital bed under Medicare, you must meet the following criteria:
- Have an approved and documented medical condition: Hospital beds are prescribed to individuals who require a head-of-bed angle higher than 30 degrees or specific sleeping positions that cannot be accommodated by a regular bed. Qualifying conditions range from congestive heart failure to breathing problems.
- Obtain a signed Medical Necessity Certificate: A hospital bed must be prescribed by a participating physician based on a documented medical condition. Additionally, a signed Medical Necessity certificate is required. Each bed model and add-on may have additional documentation requirements.
What will Medicare cover?
If the above conditions are met, Medicare will cover 80% of the total cost of the hospital bed for individuals enrolled in Part B. You will be responsible for a 20% copayment, and Medicare will determine whether you should purchase the bed or rent it for a 13-month capped rental period.
Your final cost will depend on various factors such as the type of bed, location, and insurance parameters.
In general, Medicare will only cover the most basic model of hospital bed that meets your needs. The following types of hospital beds are covered by Medicare:
- Manual hospital bed: A fully-manual bed that can be adjusted by turning a crank. While these beds are affordable, they require more manual effort from caregivers.
- Variable height hospital bed: In addition to adjusting the head and foot sections, patients can also adjust the overall height of the bedframe to facilitate transfers.
- Semi-electric bed: While the bed height requires manual adjustment, the head and foot adjustments can be made using a handheld remote.
- Heavy-duty hospital bed: Designed for bariatric patients who require additional support, these beds are extra-wide and can accommodate patients over 300lbs.
If deemed medically necessary, Medicare may also cover other items such as bed rails and trapeze bars. However, it is important to verify the approval process with your doctor, DME supplier, and Medicare to ensure proper submission of claims.
Features not covered by Medicare: It's important to note that if you want to customize your hospital bed to meet specific needs and preferences, you will need to explore options beyond Medicare's basic coverage.
Some bed features that are not covered by Medicare include:
- Full-electric beds that are operated entirely with a handheld remote.
- Rotating beds that facilitate easier transfers.
- Customizable mattress types.
- Ultra-adjustable beds with sectioned mattresses.
- Customizable designs, frames, etc.
- Additional storage space.
- Integrated weighting space.
- Additional tilting and reclining options.
Proper sleep is crucial for good health and plays a vital role in injury prevention, memory, reduced cardiovascular risk, mood, and other important health indicators. Instead of settling for the most basic model, consider selecting a hospital bed that will best support your health needs and lifestyle.
Check out our entire collection of beds below.