Does Medicare Cover Adjustable Beds?
Medicare will cover an adjustable bed or hospital bed to be used in your home if your doctor or healthcare provider prescribes one. You must have a disease or condition that makes having an adjustable bed medically necessary. Medicare will cover 80 percent of the cost, which leaves you to pay the remaining cost and the Part B deductible.
Medicare Coverage of Adjustable Beds
As with other types of durable medical equipment (DME), adjustable beds or hospital beds can be covered by Medicare for use in your home. Adjustable beds can be useful for several different conditions but must be considered a medical necessity for Medicare to cover one.
Medicare covers beds if your body needs constant repositioning to alleviate pain and illness or if you have a condition that requires attachments or devices that do not configure with a regular bed.
According to the U.S. National Library of Medicine, using a hospital bed in your home can be as effective as staying in one in an inpatient facility, but much cheaper.
- Reduce pain
- Help your body alignment
- Prevent contractures
- Prevent respiratory infections
Many different diseases or conditions could make an adjustable bed medically necessary such as cardiac disease, COPD or paraplegia.
Medicare coverage includes other parts and equipment related to an adjustable or hospital bed, such as side rails, but it depends on your condition. A variable height feature is also available if you have certain conditions like severe arthritis or some cardiac conditions.
A bed with electric-powered adjustments is also covered if you have a condition where your body position needs to be changed often. You would also need to operate the controls of the adjustments independently unless you have a brain or spine injury.
Privately insured Medicare Advantage plans could also offer added coverage for an adjustable bed. These plans include everything that Original Medicare covers, as well as other benefits and coverage.
Check with your plan provider to learn the expanded options available to you for an adjustable bed, types of beds or related equipment.
Expected Medicare Costs for Adjustable Beds
Medicare will cover 80 percent of an adjustable or hospital bed cost if your doctor or health care provider prescribes it. After meeting the Part B deductible, you are responsible for the remaining 20 percent.
Your doctor who prescribes the bed and the supplier must be enrolled in Medicare for coverage to happen.
Medicare would not pay for equipment if it were prescribed by a doctor who is not enrolled, leaving you with 100 percent of the cost of the bed.
Depending on the supplier, you may need to rent or buy a bed. You may choose between the two options or choose one based on availability and what Medicare will cover.
6 Cited Research Articles
- U.S. Centers for Medicare & Medicaid Services. (2020, February 13). Local Coverage Determination (LCD) For Hospital Beds. Retrieved from https://www.cms.gov/medicare-coverage-database/details/lcd-details.aspx?LCDId=33820&ContrId=389
- U.S. National Library of Medicine. (2004, August 7). Hospital at home for patients with acute exacerbations of chronic obstructive pulmonary disease: systematic review of evidence. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC506849/
- U.S. Centers for Medicare & Medicaid Services. (2001, December 11). Medicare Coverage Issues Manual. Retrieved from https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/downloads/R148CIM.pdf
- U.S. Centers for Medicare & Medicaid Services. (n.d.). Durable Medical Equipment (DME) Coverage. Retrieved from https://www.medicare.gov/coverage/durable-medical-equipment-dme-coverage
- U.S. Centers for Medicare & Medicaid Services. (n.d). Hospital beds. Retrieved from https://www.medicare.gov/coverage/hospital-beds
- U.S. Centers for Medicare & Medicaid Services. (n.d.). National Coverage Determination (NCD) for Hospital Beds. Retrieved from https://www.cms.gov/medicare-coverage-database/details/ncd-details.aspx?NCDId=227