You need a lot of coverage from your Medicare coverage to protect you from any health concerns that may come your way. Hospital beds are a common need, and, yes, Medicare covers them. Here are some more details on how your home hospital bed is covered.
When Medicare Covers Home Hospital Beds
Original Medicare (Parts A and B) includes coverage for items and services considered “medically necessary” by a licensed professional. Home hospital beds fall under the category of coverage known as “Durable Medical Equipment” (DME).
There are a few ways your home hospital bed is qualified as “medically necessary:”
- Your medical condition requires you to have a home hospital bed.
- You’re under the care of a doctor and are seen at least once every six months.
- Your doctor orders the bed for home use and includes why a hospital bed will benefit you.
- Medicare will provide coverage for you to rent or buy a bed.
- Your doctor and equipment provider participates in Medicare.
As you can see, there are plenty of ways to qualify for coverage if you need it for health issues such as:
- Arthritis, osteoporosis, or another chronic pain condition.
- Heart conditions require you to keep your head, heart, or limbs elevated.
- A condition that requires you to be repositioned for pain or pressure relief.
- A spinal cord condition or injury.
- A chronic obstructive pulmonary disease that’s affected by your sleeping position.
Medicare will not cover every type of hospital bed. In fact, Medicare will only consider an adjustable bed as durable medical equipment (DME) if the bed allows a person to elevate different body parts as necessary, with adjustable side rails.
However, there are specific upgrades and specialized adjustable beds and features that Medicare covers as well, including:
- Air-fluidized beds
- Built-in weight scale
- Electric power adjustments
- Extra-wide hospital bed
- Gel or gel-like pressure mattress pad
- Lambswool, sheepskin, and synthetic pads
Just remember, if you are requesting coverage for a specialized bed or feature, it must be deemed “medically necessary” as well. The bed can also only be twin-sized and must come from a Medicare-approved supplier.
How Much Medicare Pays
The specific amount Medicare covers largely depends on the type of bed you purchase. In other words, we can’t tell you upfront how much Medicare will pay relative to the actual cost of the bed. However, you can easily determine the amount covered through cost-sharing. This simply means that Medicare covers their share, then you pay what’s left.
Medicare will pay for 80% of the amount that is Medicare-approved for the purchase of a hospital bed for home use. If you have a Medicare Advantage plan, it may cover more. Or, if you have a supplemental Medicare plan, it may cover 100%. Otherwise, you’ll pay the remaining 20%.
Get the Coverage You Need with Game Changing Benefits
Our goal is in the name–we want to give you the best insurance benefits out there and completely change the way you think about Medicare. To learn more, call Game Changing Benefits at 972-331-1060.