Does Medicare Cover For A Lift Chair – Who benefits? Does Medicare Cover Lift Chairs? Cost of lift chairs through Medicare Eligible for coverage How to pay Getting started
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Does Medicare Cover For A Lift Chair
For people who qualify, Medicare will cover a percentage of the cost of a lift chair, as it is considered durable medical equipment. That said, Medicare only covers items it deems medically necessary, in this case the lift machine, which usually costs about $500. Medicare does not cover the seat portion, even if it is built into the chair.
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Lift chairs, which look very similar to traditional recliners, help users go from sitting to standing with the push of a button. When the seat is raised at an angle, its angle eases the rider into a standing or sitting position. Some lift chairs have additional amenities such as heating and massage. Others allow users to recline in a completely flat position, facilitating sleep or relaxation.
Words that are often confused: Be careful not to confuse a lift chair with a stair or patient lift. Stair lifts transport you safely from one level of your home to another, with a chair designed to slide up and down the stairs and back. Patient lifts help adults move from their bed to a chair, or usually a wheelchair.
Ideal for seniors who struggle with balance, mobility or pain, booster seats can help those who struggle to sit or stand. They are especially useful for people with muscle or joint disorders and for people recovering from surgery.
Although Medicare provides coverage for lift chairs, it does not cover all costs associated with the chair. Coverage varies depending on the type of Medicare you are enrolled in. Additionally, Medicare only helps pay for the cost of the hip lift device, not the materials, cushions, accessories, or additional enhancements. This is because these parts of a lift chair are not considered medically necessary.
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Medicare Advantage providers (private insurance companies you choose instead of traditional Medicare) are required by law to offer the same benefits as Medicare, if not more. As such, you can expect comparable elevator replacement options. Additionally, each type of coverage comes with specific provisions regarding eligibility for power wheelchair reimbursement.
Lift chairs are classified as durable medical equipment or DME. DME is essential equipment that you use repeatedly for medical purposes in your home for more than 3 years. More familiar examples of DME include walkers, portable oxygen concentrators, hospital beds, wheelchairs, and blood glucose monitors.
FYI: Not all oxygen concentrators are created equal. For our favorites, check out our list of the best portable oxygen concentrators this year.
Lift chairs can be expensive, usually from $400 to $2,000, depending on the supplier and additional features. The average cost of a lift chair is around $700.
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However, there is good news. If you have a prescription and purchase through a participating Medicare provider, you should be reimbursed 80 percent of the cost of the motorized chair lift. This typically lowers your total cost by about $300, meaning your out-of-pocket cost for a lift chair can be as little as $100. If you buy a chair at an average price of $700 and get an average refund of $300, the total cost will be about $400. Having additional insurance or discounts can also help reduce your final cost.
Remember, you must meet your Medicare Part B deductible before Medicare starts paying 80 percent for approved products and services. If you haven’t met your deductible yet, expect to pay $203 in 2021 before you get your 80% coverage.
Also, if Medicare has previously paid for another motorized device, such as a scooter or wheelchair, it likely won’t cover a lift chair.
Use the step-by-step process outlined below as a guide to securing reimbursement for your wheelchair through Medicare.
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Obviously, the right coverage is the first step before purchasing a lift chair that will be reimbursed by Medicare. This includes signing up for Medicare Parts A and B, paying your monthly premiums and meeting your annual deductible.
Once you reach your $203 deductible, Medicare Part B covers 80 percent of Medicare-approved DME purchases. In the case of a lift chair, this means that Medicare reimburses 80 percent of the cost of the lifting equipment used by the lift chair. Unfortunately, the government does not consider the hip portion of a lift chair to be medically necessary, which means that you will be financially responsible for the cost of the chair itself and 20 percent of the cost of the lift system.
Work with your Medicare enrolled physician to determine if a booster seat is a medically necessary step for you or your loved one. If you decide to go ahead with purchasing a booster seat, be sure to get a prescription and complete and submit a booster seat medical necessity form to your provider.
When shopping for your lift chair, you should ask any potential seller whether or not they are a participating Medicare provider. If they are not, Medicare will not reimburse you for the lifting device. You may want to start your search by entering your zip code on the Medicare Medical Equipment and Suppliers page to avoid problems in the future. When you find a Medicare-approved provider that offers the chair you want, verify their approval and go ahead and make your purchase.
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In most cases, you must purchase your lift chair in advance and then submit all necessary information to Medicare for reimbursement. Medicare will approve your eligibility after you confirm that your prescription dictates the medical necessity of the chair and that you use a participating Medicare provider. You don’t want to find out you’re not eligible for a refund after you’ve paid for the chair, delivered it, and gotten used to it.
After you make your purchase, most Medicare-approved vendors will submit a claim to Medicare. But you can also send it yourself. Claims submitted online are processed faster and can take up to 14 days. All claims will normally be processed within 30 days.
Even if Medicare doesn’t cover the entire cost of your lift chair, it can certainly be a great way to offset the high price tag. Make sure you get your prescription and save your receipts to make sure you get the compensation you deserve.
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As a Medicare expert for Medigap.com, Lindsay Malzone has extensive experience helping seniors understand the ins.