If you hold a Medigap or Medicare Advantage plan, you may be eligible for extended coverage related to hospital beds.

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Under Medicare Part B, all medical equipment, which includes hospital beds, is covered. Specifically, Part B takes care of 80% of the hospital bed expenses.

To ensure coverage, the hospital bed must be deemed medically necessary for your condition. A physician must prescribe the bed and demonstrate how it will be beneficial for your health issues.

There are several reasons why your healthcare provider might recommend a hospital bed for home use. This could include severe discomfort, breathing challenges, or significant leg and foot swelling.

When there is a medical necessity, Medicare will finance hospital beds for in-home usage. A physician's prescription indicating the need for the bed is required. Medicare Part B covers 80% of the total cost, but Medigap or Medicare Advantage plans could further assist with the costs.

Whether you opt to rent or buy a hospital bed will depend on your doctor's recommendation and the policies of the supplier. Initially, you may choose to rent a bed and later decide to purchase it if your needs persist.

Medicare covers the option to either rent or buy a hospital bed.

Eligibility for Medicare coverage on your hospital bed is as follows:

Hospital beds intended for home use qualify as durable medical equipment (DME) and are covered under Medicare Part B. To fulfill the coverage conditions, your hospital bed must meet specific criteria.

Typically, coverage is facilitated through different parts of Medicare. If you hold both Medicare Parts A and B, collectively known as original Medicare, your coverage for the hospital bed will be through Part B, as Part A pertains to inpatient care in hospitals and skilled nursing facilities.

Medicare Part B caters to various healthcare needs, which encompass:

• Visits to the doctor's office
• Emergency room visits
• Medical equipment needs

Part B will take care of 80% of the Medicare-approved costs associated with the hospital bed; you will be responsible for the remaining 20%.

Moreover, you can explore Medicare Part C coverage, commonly referred to as Medicare Advantage plans. These plans, provided by private entities that collaborate with Medicare, are mandated to offer coverage analogous to original Medicare, in addition to potentially more services.

Since original Medicare provides coverage for hospital beds, all Advantage plans will also include this coverage. Your expenses might vary compared to original Medicare based on your chosen plan.

It is important to note that Medicare Part D relates to prescription medications and will not assist with DME expenses, including those for hospital beds.

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Additionally, Medigap can assist with the costs of obtaining a hospital bed. As a form of supplemental Medicare insurance, it covers certain out-of-pocket expenses that arise from original Medicare, such as copayments and coinsurance amounts.

Thus, if you leverage Medicare Part B to acquire your hospital bed, a Medigap plan could potentially handle the 20% coinsurance that you would typically be responsible for.

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Beds and Medicare

Beds and Medicare

Does Medicare Cover Hospital Beds?

Medicare will provide coverage for a hospital bed if a clear medical necessity can be demonstrated. You must be enrolled in Medicare Part B and undergo an assessment by your healthcare provider. The physician should document your requirement in your medical records and issue a prescription for the equipment. Only your physician has the authority to prescribe the necessary equipment.

The supplier must have the prescription before billing Medicare, and it should be documented in their records.

How Do I Qualify For a Hospital Bed?

To be eligible for a hospital bed, you must fulfill certain criteria:

• Need to reposition in ways not achievable on a standard bed
• Require specific sleeping positions to alleviate pain
• Must keep the head of the bed elevated beyond 30 degrees due to conditions like congestive heart failure or other respiratory issues
• Need to use traction equipment that must attach to a hospital bed
• Possess a Certificate of Medical Necessity that is duly filled out, signed, and dated by your attending physician

The above parameters outline the essential requirements for hospital bed coverage. Various types of hospital beds exist, including adjustable beds, each with additional specific coverage criteria. To correctly document your needs for the appropriate bed and equipment, consult your healthcare provider or supplier. Note that adjustable beds, full-electric models, and electric hi-lo beds are deemed convenience devices and are not covered by Medicare.

How Much Does It Cost to Rent or Buy a Hospital Bed?

After fulfilling your annual deductible, you'll be responsible for 20% of the Medicare-approved amount for either the purchase or rental of the hospital bed, as well as maintenance costs. With supplemental insurance, you might find your out-of-pocket expenses minimal to negligible when it comes to manual crank or semi-electric hospital beds.

Costs could rise if the supplier does not comply with assignment rules. Hospital beds fall under the Capped Rental category, allowing you the choice to rent or purchase the bed. After 10 monthly rental payments, you'll have the option to buy the bed. The supplier will issue a "Purchase Option" letter in the ninth month of the rental period, after which you have 30 days to respond.

If you decide to purchase the bed:

• Medicare will continue paying for three additional months, and the bed will now belong to you.
• You will be in charge of maintenance, although Medicare might cover some maintenance expenses.

If you do not respond or choose to persist with the rental:

• Medicare will conclude a total of 15 rental payments, and the bed will remain in your use until needed.
• The supplier retains ownership of the bed and holds the responsibility for its maintenance.
• A maintenance and service fee may be charged biannually.

Where Do I Purchase or Rent Hospital Beds?

You will achieve savings by ordering from a Medicare-approved supplier that agrees to assignment terms. Additionally, you can acquire a hospital bed from any outlet that sells them. However, if the supplier you choose to get your bed from is not authorized by Medicare, reimbursement for the equipment will not be possible.

Before settling on a supplier, consider the following:

• Two categories of Medicare suppliers exist: participating and non-participating suppliers.
• Participating suppliers cannot exceed the designated Medicare payment amounts.
• A non-participating Medicare provider may charge more than the approved sum, though they cannot exceed 15% above the authorized amount. They might request full payment upfront when you collect the bed. In such circumstances, Medicare will reimburse you directly but expect some delays as it might take a few months to receive your payment.
• If your Medicare coverage is via a Medicare Advantage Plan (such as through an HMO or PPO), there might be specific procedures for purchase, along with potential limitations on supplier choices.

Will Medicare Pay for Electric Hospital Beds?

Full electric hospital beds are not covered by Medicare as they are categorized as convenience devices. However, you may apply the cost of a manual lift towards acquiring an electric model through an Advance Beneficiary Notice (ABN). Consequently, you will be responsible for the price difference. In some instances, purchasing an electric bed directly from a medical equipment store might be more economical.

If you seek further information, please browse medical beds for sale.