Does Medicare Cover Hospital Beds to Use in Your Own Home?
Medicare Benefits Solutions
Sep 19, 2022
If you or a loved one is recuperating from an illness, injury, or surgery, it can be more comfortable to recover at home and avoid a long stay in a hospital or skilled nursing facility. Practically speaking, it may only be possible if you have access to the medical equipment you need.
Hospital beds adjust to your specific needs, make it easier for you to get up, and can make it more convenient for caregivers to provide assistance. A hospital bed can also be helpful if you’ve been diagnosed with a long-term illness or chronic condition that causes difficulties with mobility.
You may be wondering if you can get a hospital bed through Medicare and if you’ll qualify for coverage to rent or purchase a hospital bed to use at home. Depending on your needs and doctor recommendations, you may have access to Medicare benefits that will help you pay for a hospital bed.
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What is a Home Hospital Bed?
Home hospital beds are similar to the beds used in hospitals and skilled nursing care facilities, but they are adapted for use at home. Hospital beds for home care are designed to include features that a regular bed doesn’t have such as:
- Adjustable height controls (manual or electric) to elevate the entire bed, the head, and/or the feet of the bed. Patients can sit in bed to eat, watch television, read, or breathe more easily if the head of the bed is raised.
- Adjustable side railings provide security, so a patient doesn’t fall off the side.
- Lockable wheels make the bed easier to move around, but they also lock so there’s security when the patient is getting in or out of bed.
There are many specialist home hospital beds that are designed to treat various types of injuries like back or spinal injuries. For example, standing, turning, or legacy beds.
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Does Medicare Cover Hospital Beds?
Medicare covers a percentage of the cost to rent or purchase a hospital bed to use at home when you meet Medicare’s requirements for this benefit.
To qualify for this benefit, the following conditions must apply:
- Your physician must accept Medicare assignment.
- The physician must certify that the home hospital bed is medically necessary to treat your condition or to make your condition easier to manage by having special equipment or the ability to allow certain positioning that you can’t get with a regular bed.
- You must have engaged in a face-to-face visit with the ordering physician within the past six months.
- Your physician must provide a prescription for an adjustable bed. This prescription must explain your medical condition and why you need the hospital bed.
- You must have supporting documents for your physician’s diagnosis from other health care providers
- Your physician must explain the health benefit of the hospital bed.
You may qualify for an adjustable hospital bed if you have any of the following conditions:
- A condition that requires repeated repositioning because of pain or other discomforts.
- Certain cardiac diseases
- Chronic pulmonary obstructive disease (COPD)
- Spinal cord injury
- Severe arthritis
- Other types of injuries
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Does Medicare Cover the Cost of Bed Sheets?
Your Medicare coverage may not include benefits for sheets, pillows, or accessories like waterproof mattress pads. You may have to purchase sheets and accessories, but they can be found at local stores. Even though many hospital beds use twin XL sheets, you should confirm the size of the bed before buying sheets.
Medicare Advantage Coverage for Hospital Beds
If you have a Medicare Advantage (Part C) plan, your private insurance provider must cover (at minimum) the same benefits that Original Medicare Parts A and B cover. That means that if you meet Medicare’s qualification requirements, your Part C provider must cover DME like a home hospital bed and mattress.
Depending on the type of Medicare Advantage plan you have, however, you might need to rent or purchase your equipment from a medical supplier who is included in your plan’s network of medical suppliers and providers. If you aren’t sure which providers and suppliers you can use to get your coverage, you should contact your provider and ask for this information.
Because all Medicare Advantage plans have the right to set their own coinsurance amounts, your out-of-pocket costs depend on what your individual Part C plan charges.
What Types of Adjustable Beds are Covered?
If you’ve started to research Medicare-covered hospital beds, you may be wondering if Medicare covers hospital beds. Medicare typcially does not provide coverage for a fully electric hospital bed. However, through Medicare Part B coverage, you can choose one of several different types of hospital beds if you qualify for this benefit.
The types of adjustable hospital beds that Medicare covers include:
Manual hospital beds
Any adjustments you make to a manual hospital bed are done by turning a crank by hand. There may be different cranks for the different adjustments like raising the head and foot portion of the bed.
Manual beds are the least expensive of the four types of beds, but they are typically the most cumbersome for caregivers to operate. If you or the person you are caring for has a risk of falling out of bed, look for a model that also lets you adjust the overall height.
Semi-electric hospital beds
Semi-electric hospital beds have electric motors that control adjustments on the head and foot parts of the bed. The motor is connected to a hand-held control with buttons. However, you must use a hand-operated crank for the overall height adjustment.
Bariatric hospital beds
Bariatric beds are suitable for accommodating larger individuals, have a sturdier frame and are usually wider than a standard hospital bed. Bariatric beds are typically available in heavy-duty models that support up to 500 pounds and super heavy-duty models that support up to 1,000 pounds. Some versions also have variable width and length options for complete customization.
Does Medicare Cover Hospital Bed Mattresses?
You can rent or purchase your hospital bed without or with a mattress which Medicare does cover. Your benefits will also cover the following items related to the hospital bed:
- Mattress pads
- Synthetic or natural sheepskin pads
- Gel, dry, air, or water pressure pads
Medicare may also cover additional features that are certified as medically necessary but not those that are strictly for convenience.
Renting vs. Buying a Home Hospital Bed
Depending on the type of DME, Medicare may give you the option to purchase or rent the equipment. If you rent the hospital bed and mattress, you pay monthly payments to the Medicare-affiliated supplier. If you purchase the equipment, you pay one lump-sum amount, and then you own the equipment.
In either case, if you qualify for Medicare coverage, you pay 20 percent of the rental fee or the final purchase amount after Medicare pays its share of 80 percent.
If you are caring for a loved one at home, or if you need a safer and more comfortable bed to help you recuperate, your Medicare benefits may cover one that suits your needs. Medicare’s coverage of durable medical equipment may save you money and allow you to stay in your home while you get the care you need.
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