by For those who don’t know, Medicare covers adjustable beds. The Part B of Medicare is all about adjustable beds. This part pays for the outpatient medical costs and includes durable medical equipment such as adjustable beds.
Medicare will cover all this when your doctor orders such a bed or other equipment covers here for you that you can use in your home. To make sure this works out, you must ensure that Medicare providers cover your doctors and the company that will supply the adjustable bed (also check 10 amazing mattresses for an adjustable bed).
You have the option of choosing between renting or purchasing the bed. So, which brand is covered under Medicare? Here’s everything you need to know about it! Saatva adjustable bed is unfortunately not covered by Medicare as far as we know but you can still benefit from a nice 0% APR with affirm which is not common for such quality bed.
Our #1 Adjustable bed we tested (not covered but you can get 0% APR with affirm..)
The premium-quality adjustable bed frame is covered under Medicare (with limitation)
If you want the best adjustable bed covered under Medicare, you must consider going for the GhostBed adjustable beds and bed frame.
It has an independent head and foot adjustment to ensure full customizations according to your requirements and needs. You can make these adjustments using single buttons.
With a remote, you can use various settings for watching TV, reading books, zero gravity, and anti-snoring. This bed can deliver whisper-quiet massage in three different modes, and you can choose from three different intensities. There are easy-to-access USB ports available on both sides of the bed, and under-bed LED lighting is available.
Your bed will also come with remote control, and it is available in three different sizes, including Twin XL, Queen, and Split King (check the top rated split king mattresses). The bed is covered under a limited lifetime warranty.
This adjustable bed has fully customized elevation options, and multiple preset positions are available. The base is made of durable stainless steel and features anti-skid fabric to prevent your mattress from slipping on it.
This bed is straightforward to assemble within just 20 minutes if you strictly follow the instructions, and you don’t need any DIY skills under your belt either.
The feature that makes this adjustable bed stand out from its competition is its zero gravity mode. This mode alleviates your feet and head, and you will feel that no gravitation force is pulling you at all.
You can purchase the reliable GhostBed mattress with this adjustable base (also check 10 great mattresses on the market). And for the best performance, you can consider going for a range of other bedding accessories that you can purchase from GhostBed.
What is Medicare?
Medicare covers a range of different DME, which might include an adjustable bed if you meet the criteria. An adjustable bed will ensure better comfort (also check the top-quality mattresses with great comfort) and prevent further injury for people with certain medical conditions like paraplegia or broken hip.
This federally funded insurance program provides health coverage to anyone 65 or above. Some people covered under this program are end-stage renal disease and other chronic health conditions.
This program is divided into these parts to provide different aspects of health coverage.
- A is the portion that deals with inpatient stay at any skilled nursing facility in a hospital.
- B covers doctor’s visits, medical testing, medications like vaccinations and infusions, and DMEs, including adjustable beds.
- C is covered by private companies and is known as Medicare Advantage. Some benefits it offers are prescription drug plans and hearing, vision, and dental care plans.
- D covers prescription drugs.
What is an Adjustable Bed?
People use a general term for a bed that doesn’t stay stationary or flat. These adjustable beds enable you to elevate or move various components of your bed to meet different needs and requirements (also check 10 top-rated sheets for adjustable bed).
A common example is a regular hospital bed that enables you to elevate your feet and head according to your requirements. This adjustable bed allows you to adjust the height of your feet and your head; hence, it gets its name “the adjustable bed.”
What’s a DME?
DMEs or durable medical equipment can include beds, walkers, oxygen equipment, crutches, and chairs. The federally funded insurance program includes adjustable beds, and they are categorized into different types.
- Used in a person’s home.
- Have some medical purpose.
- Come with a lifetime of at least 3 years.
- Durable enough to withhold daily use.
When Medicare Covers Adjustable Beds?
Medicare covers adjustable beds, but you need a particular medical need for it. For instance, you need to visit your doctor or provider face to face within 6 months of the order that your doctor placed for the bed.
And to make it work, you must be enrolled in Part B of Medicare, authorizing you to have an adjustable bed. This part authorizes you to get any other medical equipment covered.
But if you want to be covered under Medicare Part B, you need to fulfill the following conditions:
- You must have a condition that requires special equipment that cannot be treated using the standard bed.
- You must have the prescription from your doctor for this adjustable bed, describing your condition and why it needs an adjustable bed for the treatment. Since the GhostBed adjustable base motor is hospital grade, you can save a few hundred dollars if you get a doctor’s note for hospital grade
- All medical records that support the requirement and need for an adjustable bed should be there.
- You must have the physician resorts that provide details on the medical condition for which this particular bed is required.
Some conditions that might require you to have an adjustable bed are,
- If you have any cardiac diseases,
- If you have a chronic pulmonary obstructive disease.
- Those of you who need regular body positions to tackle pain, poor alignment, or contractures (also check the best selling mattresses for back pain).
- Severe injuries or arthritis.
- Various spinal injuries such as paraplegia or quadriplegia (also check 10 great mattresses for scoliosis).
Which Adjustable Beds Medicare Covers?
The Part B of Medicare covers all basic hospital beds under its rule. But there are a few options and exceptions that you can explore only if your doctor thinks they are mandatory for your recovery.
For instance, any adjustable features for the height of the bed, an electric-powered bed, or those side rails are not part of the coverage. However, these can be added to the range if your doctor thinks they suit your faster recovery.
They might still have some coverage limitations. But Medicare will pay for at least a portion of the coverage if your doctor includes these additions to treat your condition.
Medicare covers various other bedding items and other extras for your bed. Here’s the list of these items covered under Part B of Medicare.
- Pressure mattress pad that is made of gel or any other gel-like material.
- A pad made of lambswool sheepskin.
- A pad made of synthetic sheepskin.
- Beds that are fluidized by air.
- Beds that have air pressure pads for regular mattresses
- Those beds have water pressure pads for regular mattresses.
- Dry pressure pads for standard mattresses.
- Hospital beds with fixed height, including or excluding side rails or mattresses.
- Beds with adjustable height, including or excluding side rails or mattresses.
- Semi-electric beds with foot and head adjustment, including or excluding side rails or mattresses.
- Fully electric beds with foot and head adjustment, including or excluding side rails or mattresses.
- Extra wide or heavy duty bed with side rails and its max laid capacity is between 35 lbs and 600 lbs or above, including or excluding mattress (also check 10 top-rated mattresses for overweight person).
- Fully-enclosed hospital-grade pediatric crib.
What Type of Bed Will Medicare Pay for?
Medicare has to consider an adjustable bed as a DME (durable medical equipment) only if you can adjust it from the head or foot. In other words, your bed must allow you to alleviate various body parts as per requirement. It must have side rails that you can raise or lower as necessary.
Medicare might cover a part of the cost for any mandatory modifications to your adjustable bed, like a bed that is fluidized by air to reduce its pressure. Various other adjustments that are covered under Medicare are,
- Inbuilt weight scale
- Adjustment using electric power.
- Hospital bed with extra width.
- Pressure mattress pad made of gel or any other gel-like material.
- Pads made of sheepskin or lambswool.
How are Medicare Covers Adjustable Beds That in the Home?
Medicare covers adjustable beds present in the home as well. But you have to provide them with evidence that these beds are medically mandatory for you. For example, if you need frequent repositioning because of pain rustling from cardiac disease, severe arthritis, or spinal injuries.
Any disability that needs you to use such an adjustable bed has to be there. Therefore, you will have to abstain from a medical prescription from your doctor, which should be backed with different medical records.
For example, a specific bed type is needed, and it should have rails, or any exceptional mattress must be provided in that prescription. Since the GhostBed adjustable base motor is hospital grade, you can save a few hundred dollars if you get a doctor’s note for hospital grade.
When you have met these conditions, Medicare will pay you 80 percent once you have paid the deductible portion of Medicare’s Part B. Examples of DMEs link with these adjustable beds,
- Water or air pressure pads for mattresses.
- Beds that are fluidized by air.
- Beds that have a max load capacity of over 600 lbs.
- Pediatric cribs.
- Hospital beds with a fixed height.
- Mattress pads that have gel-based pressurizing.
- Semi-electric hospital beds.
- Hospital beds that come with variable or adjustable height.
- Electric beds that come with a foot or head adjustment.
Does the “Medicare Advantage” Plan Also Cover Adjustable Beds?
The MA (Medicare Advantage) plans might cover the costs of these adjustable beds. But these plans don’t come with standardization. Instead, carriers determine how many portions of the coverage they will offer.
You can use Medigap Plans to fill in the gaps Medicare doesn’t cover. For instance, Medigap plans can typically pay that 20 percent left balance from the 80 percent balance that Medicare Plan B pays. The Medigap Plan F covers the Part B deductible and the 20 percent balance from Medicare.
How Much Does An Average Adjustable Bed Cost?
The overall cost of an adjustable bed heavily depends upon various factors, such as:
- The model of the bed.
- Its additional options and features.
- Which brand or supplier you have opted for.
- Any additional insurance that you might have.
In general, the prices range from USD 500 to USD 30,000. Some of the most expensive beds are those ICU beds available only for rentals. You might find some suppliers that can refurbish any used beds and sell or rent them.
If you choose suppliers that can accept Medicare, the insurance program will pay 80 percent of the amount, and you will only have to pay 20 percent of the balance.
Apart from that, you will have to pay the Part B deductible. And without Medicare, you would have been paying the entire amount of the bed or would have gone for private insurance.
Eligibility & Costs
For anyone who needs to be eligible for these adjustable beds qualifying as DMEs under Plan B of Medicare, their doctor has to write a prescription that mentions the medical necessity of such a bed.
As per the requirements for eligibility, an adjustable bed is a medical necessity for a person needing:
- Positioning for pain relief or body alignment.
- Positioning for improving respiratory function.
- Special attachments like traction devices that are not possible traditionally attach to a bed.
In this prescription, the doctor has to describe the conditions of the person and diagnosis to explain the medical necessity of such a bed. These conditions include chronic obstructive pulmonary disease, severe leg injuries, paraplegia, and others.
Though the insurance program assists in paying for these adjustable beds, you will still be responsible for paying a portion of these costs. Various factors can directly influence these costs, for example, the type of the bed or whether you purchase or rent it.
Conclusion
We highly recommend using GhostBed Adjustable Bed since the GhostBed adjustable base motor is hospital grade. So, save a few hundred dollars if you get a doctor’s note for hospital grade.
Well, you can use adjustable beds from any other brand, and the Plan B of Medicare will take care of it as long as the doctor recommends it to treat your medical condition.
You will only have to provide them with the details about the prescription and must back it with other medical records, and the insurance program will cover up to 80 percent of the cost of your adjustable bed. You have the option of going for the Medigap Plan F to cover the rest of the 20 percent balance as well as the Plan B deductible amount.
Adjustable beds covered by Medicare FAQs
Can you use a regular mattress with an adjustable bed frame?
No, you can’t just use any mattress on your adjustable bed. It's because not every mattress type is compatible with such a bed. But if you have a compatible mattress, you can use an existing mattress with a bed that has an adjustable base. In most cases, any mattress not innerspring is consistent with these adjustable bases.
Do adjustable beds have health benefits?
Yes, adjustable bed bases can assist you conveniently in elevating your legs or head. They can be medically beneficial for various reasons, including alleviating snoring, reducing back pain, and proper spinal alignment. So, anyone dealing with rehab from injuries or other severe medical conditions can benefit from using these adjustable beds.
Will Medicare pay for a Tempurpedic adjustable bed?
Yes, Medicare will provide coverage for any rental or purchase of adjustable beds that you can use in your home. But it must be medically mandatory to treat your medical conditions, and the doctor should prescribe it. These adjustable beds are durable medical equipment under Part B of Medicare.
Does Medicare cover mattress toppers?
The Part B of Medicare usually covers any support surfaces that reduce pressure under the heading of durable medical equipment or DME.