May 9th 2024
By Ari Parker
Discover if Medicare covers hospital beds and what you need to know about eligibility and coverage options in this article.
Some people with chronic conditions or limited mobility may benefit from having a hospital bed at home. Hospital beds have better positioning options, side rails, and other characteristics that enhance comfort.
Medicare covers hospital beds when they’re medically necessary for use at home. In this guide we’ll share how coverage works, how much hospital beds cost on Medicare, and some of the other types of beds and mattresses Medicare covers.
Medicare covers hospital beds if your doctor recommends one for use at home.
Medicare will pay for 80% of the cost of the hospital bed once you’ve met your Part B deductible.
Make sure you rent or purchase a hospital bed from a Medicare-approved agency or you may have to pay more.
Hospital beds are very different from regular beds and are intended to provide comfort and functional benefits for people fighting medical conditions. These beds have special features including adjustability, side rails, wheels, and attachment points for medical equipment (like IV poles). You can also get specialized mattresses to prevent bedsores and improve circulation. Electric hospital beds have the most flexibility since you can control your position on your own.
You may need a hospital bed if you experience any of the following:
You have a chronic illness, like muscular dystrophy or multiple sclerosis (MS), that limits your mobility.
You’re recovering from surgery or an injury and you need a hospital bed for more support during the healing process.
You need a hospital bed that easily allows you to adjust positions to manage a medical condition that gives you respiratory problems or circulation issues.
You need a hospital bed for hospice care. Hospital beds can also make it easier for caregivers to provide assistance during this time.
A hospital bed is a good option for people who need hospital-level care, but wish to remain in the comfort of their own home.
Medicare covers hospital beds at home if your doctor prescribes one. Hospital beds are considered durable medical equipment, and Medicare has certain rules for how it covers these devices.
Medicare Part B is responsible for medical equipment, including hospital beds. Once you’ve met your Part B deductible for the year, you’ll owe 20% of the cost of the hospital bed. Medicare will pay for the other 80%.
Depending on your hospital bed supplier, you could either rent or buy the equipment. Some suppliers offer both options. Some rules and costs are different if you rent vs. buy the hospital bed. For example, Medicare helps pay for the cost of maintenance for a hospital bed if you choose to rent the equipment.
There are three eligibility requirements for Medicare to cover a hospital bed:
Your doctor says that you need a hospital bed at home.
Your doctor accepts Medicare.
You rent or purchase the hospital bed through a Medicare-certified agency.
If you don’t meet any of this criteria, you could end up paying more—or even the entire cost of a hospital bed. The more affordable hospital beds can cost anywhere from $800 to $2,000, so getting stuck with the full price could put a big dent in your wallet. Make sure that your supplier is enrolled in Medicare to receive full coverage and avoid any excess charges.
By law, Medicare Advantage plans have to cover the same services and equipment as Original Medicare. However, Medicare Advantage plans are offered by private insurance companies, which means that they can set their own rules for costs and suppliers.
Your out-of-pocket costs for a hospital bed won’t be the same as Original Medicare and can differ between Medicare Advantage plans. Plus, your plan will have its own set of healthcare providers and medical equipment providers who are within the plan’s network. You’ll need to receive equipment from suppliers who are in your plan’s network to avoid overpaying..
Get in touch with your insurance provider or check your summary of benefits to get a sense of what your costs will be for a hospital bed.
Medicare also covers other types of mattresses in addition to hospital beds. As an example, you can receive Medicare coverage for an air-fluidized bed if it’s medically necessary. People with arthritis, burns, and stage II pressure ulcers may qualify for an air-fluidized mattress for extra support and comfort at home.
We’re here to help with any and all questions about your Medicare concerns. Whether you have questions about coverage for equipment and supplies or other elements of your Medicare coverage, our licensed Medicare agents have you covered. Call us at 855-900-2427 or schedule a time to chat to get started today.
