Are you signed up with Medicare and in need of an adjustable bed? We have many seniors asking every day, “Will Medicare pay for an adjustable bed?” and, luckily, the answer is yes; Medicare will cover an adjustable bed.
As is the norm, however, a patient should meet specific criteria before Medicare covers any adjustable bed purchases. In brief, Medicare will cover your adjustable bed if:
- You are registered for Medicare Plan B (part of original Medicare).
- You have a prescription qualifying you to receive an adjustable bed as part of your medical treatment.
- Your adjustable bed meets certain requirements outlined by Medicare, detailed below.
- You get it from a Medicare supplier.
When Does Medicare Cover Adjustable Beds?
Medicare will cover adjustable beds for eligible patients when doctors prescribe them as durable medical equipment (DME). Medicare covers adjustable beds if they abide by these guidelines:
- They are durable. They must be able to withstand repeated use. Medicare generally defines “repeated use” as lasting at least three years.
- One must use the adjustable bed for medical purposes only.
- The adjustable bed must not be particularly useful for someone who isn’t sick or injured.
- The bed must be usable in your home.
Who Is Eligible for An Adjustable Bed?
Every person enrolled in Medicare Part B (which is part of original Medicare) is eligible for an adjustable bed if they fulfill certain other requirements. Medicare will consider coverage if you have:
- A condition that makes positioning not possible with a standard bed (for example, a condition that requires special equipment)
- Detailed medical records that indicate an underlying need for the adjustable bed.
- A prescription from your doctor that calls for an adjustable bed.
If you think you are eligible for adjustable or home hospital beds covered by Medicare, you should first consult your primary care physician. If your doctor writes you a prescription for a DME to have at your home, you should have another follow-up appointment within six months of the doctor’s writing the prescription.
Which Types of Adjustable Beds Will Be Covered?
By definition, any adjustable beds covered by Medicare must be adjustable either from the head or the foot of the bed. This adjustability allows a person to elevate their various body parts as necessary. This requirement is one of the ways Medicare guarantees their subsidies are being used for medical use.
In order to be covered by Medicare, your adjustable bed should also have side rails that are manipulable manually or electrically.
In addition, Medicare has in some cases covered modifications to existing adjustable beds. One example of this is modifying electric beds covered by Medicare to be air-fluidized (a modification to an adjustable bed meant to decrease pressure on individual bony body parts “through body ‘flotation’”).
Beyond that, Medicare may cover:
- Adjustable beds equipped with a built-in scale
- Extra-wide beds
- Bed pads (e.g., lambswool or sheepskin)
- Gel pads (or gel-like pads) to reduce pressure
- Beds with electric power adjustments
How Much Does the Average Adjustable Bed Cost?
One thing to note about an adjustable bed’s cost: anyone on Medicare Plan B will only pay 20 percent of the adjustable bed’s total cost (Note: this is not inclusive of your deductible, which you still must pay to your doctor). Medicare will cover the other 80 percent of your adjustable bed.
That said, the average adjustable bed varies widely in cost — an adjustable bed can run anywhere from $500 to $30,000 (note: $100 to $6,000 after Medicare).
Why such a price disparity? The extant features and size vary tremendously from bed to bed; thus, the price fluctuates.
What Impacts the Price of an Adjustable Bed?
Many factors impact the price of an adjustable bed. Here are just a few.
Is the Bed Electric or Manual?
There are three categories of adjustable beds: manual, semi-electric, and full-electric hospital beds.
Manual hospital beds are the traditional hospital beds. One operates an adjustable bed, as the name implies, free of electricity. These beds are adjustable using a hand crank located on either the head or the foot of the adjustable bed.
The downside of these beds is that often those with a need for an adjustable bed can’t make the adjustment themselves. The upside is the price. Usually, manual hospital beds will start at $500.
Semi-electric Hospital Beds are the middle road between the fully automated electric beds and the completely hand-operated manual beds. Semi-electric hospital beds generally have a hand crank to adjust the height and a remote control that allows for the head and feet’ actual positioning to get adjusted.
Full electric hospital beds are exactly as their name suggests: height and positioning are all done electronically. For all the convenience, these beds possess a zero or two to the price tag: these beds start at about $2,000.
The dimensions of your adjustable bed will also be influential in determining the price. The larger your bed, the more you’ll pay. The standard hospital bed is 38 inches wide and 84 inches long, but some extension kits add another four inches onto the length (ideal for those whose length reaches into the upper echelons of 6-and-a-half feet or more).
The more weight an adjustable bed can support, the more the cost. Typically, manufacturers engineer hospital beds to support a weight of up to 450 pounds. Beyond this 450-pound limit, a bariatric bed is necessary, and most bariatric beds are fully electric. Thus, a bariatric bed can cost up to three times more than your run-of-the-mill adjustable beds.
Adjustable beds will require different bedsheets, and these will get added to the ultimate price you pay. A typical hospital bed is of twin-size width but of a greater length to accommodate extra equipment like IV poles and generators. Bedsheets for your hospital bed, being specialized, won’t be cheap as bedsheets go: they’ll run you up to $50.
Medicare may cover the mattress pads in addition to your hospital bed, and it may not, depending on your case. Nevertheless, mattress pads are typically necessary for adjustable beds for comfort and pressure reduction.
Different kinds of mattress pads are available, and each type sees a different rate in the marketplace. The different variety of mattress pads are air, gel, foam, and other gel-like mattress pads. Though the prices vary, you can imagine an average price of $100 for a good mattress pad.
Trapeze bars, which may be required for Medicare coverage, assist you in switching positions in the bed, are manually adjustable and are positioned on either side of the bed. These bars will add upwards of $200 to the price of your adjustable bed.
IV poles can be included in a DME bed, but these poles will increase the price. IV poles can be purchased as freestanding or already attached to your adjustable bed, but they’ll run you about $50 more.
How Much Does It Cost to Rent a Hospital Bed?
According to the Medicare Plan B guidelines, some will be required to rent a hospital bed. If your situation is temporary, renting a home bed may be a better option than buying an adjustable bed outright. Typically, these beds cost $200 – $500 for a month’s rental.
Can You Get a Hospital/Adjustable Bed If You Have a Medicare Advantage Plan?
Adjustable beds covered by Medicare are available with a Medicare Advantage Plan if your plan covers the same medically necessary DME items as Original Medicare Parts A and B. Costs can vary depending on your specific plan.
Are you unsure whether your Medicare Advantage Plan covers your adjustable bed? If your adjustable bed qualifies as a DME, you can call your primary care provider and ask.
Full descriptions of what your Medicare Advantage Plan will cover should be easily accessible in its “evidence of coverage” document. If you’re in the process of getting a new Medicare Advantage Plan and you’re currently using a DME, you should be sure that any new plan you consider will continue to cover your needed home medical equipment use.
If Your Medicare Advantage Plan Doesn’t Cover Your Adjustable Bed
If your Medicare Advantage Plan doesn’t cover your adjustable bed, you can appeal this decision and get an independent review of your coverage request.
Will Medicare pay for an adjustable bed? Well, quite simply, yes. Medicare will cover your adjustable bed if you meet certain basic requirements.
As we’ve mentioned in the article, you must be registered for Medicare Plan B (part of original Medicare), must have a prescription from your PCP, and must have a bed that qualifies as durable medical equipment under Medicare guidelines.
If you can check all three boxes, you’re in luck! Medicare will pay for 80 percent of the total cost of your adjustable bed (not including the deductible).