Does Medicare Cover Adjustable Beds?

Adjustable beds can significantly enhance comfort, improve sleep quality, and provide essential support for individuals with medical conditions. If you or a loved one require an adjustable bed for health reasons, you may be wondering: Does Medicare cover adjustable beds?

Quick Answer: Yes, Medicare Part B covers adjustable beds under durable medical equipment (DME) if they are deemed medically necessary by a doctor. However, coverage comes with specific conditions, including a doctor’s prescription and supplier approval by Medicare.

Our Top Picks for Best Adjustable Beds Covered by Medicare

If you’re looking for an adjustable bed that qualifies for Medicare coverage, here are three top-rated options:

Invacare Full-Electric Homecare Bed

Ideal for individuals needing full adjustability, this bed features easy height adjustments and a user-friendly remote control for comfort.

Drive Medical Ultra-Light Plus Electric Bed

A lightweight yet sturdy option that meets Medicare’s DME requirements, making it an excellent choice for home care.

Medline Alterra 1385 Hi-Low Bed

Provides enhanced safety features, making it perfect for seniors and patients needing frequent positioning changes.

How Does Medicare Classify Adjustable Beds?

Medicare classifies adjustable beds as Durable Medical Equipment (DME), which includes items designed for repeated use in a home setting to treat medical conditions. DME must meet specific requirements to be eligible for coverage under Medicare Part B.

To qualify, an adjustable bed must

• Be prescribed by a Medicare-approved doctor.
• Be medically necessary to treat a condition, such as sleep apnea, spinal injuries, or mobility issues.
• Be supplied by a Medicare-approved DME provider.

Who Qualifies for Medicare Coverage of Adjustable Beds?

Medicare will only cover an adjustable bed if the patient meets strict eligibility criteria. You may qualify if:

• You have a medical condition requiring frequent repositioning, such as arthritis, chronic pain, or post-surgery recovery.
• Your doctor provides a written prescription stating that an adjustable bed is medically necessary.
• You are enrolled in Medicare Part B and have met your deductible for the year.

Certain conditions make it easier to get approval, including

• Severe arthritis or joint issues requiring elevation or support.
• Heart conditions where sleeping at an incline improves circulation.
• Respiratory diseases that require upright sleeping positions.

How Much Does Medicare Cover for Adjustable Beds?

The cost of an adjustable bed through Medicare depends on various factors, including deductibles, co-pays, and the supplier’s participation in Medicare. Here’s what you need to know:

• Medicare typically covers 80% of the cost after you meet your Part B deductible.
• You are responsible for the remaining 20%, unless you have supplemental insurance (Medigap) to cover it.
• If you rent an adjustable bed through a Medicare-approved supplier, Medicare will cover the rental costs for up to 13 months, after which you may own the bed.

How to Apply for a Medicare-Covered Adjustable Bed

Applying for Medicare coverage for an adjustable bed requires several steps:

1. Consult your doctor – Obtain a prescription that clearly states why you need an adjustable bed for medical purposes.
2. Choose a Medicare-approved supplier – Find a durable medical equipment (DME) provider enrolled in Medicare’s supplier directory.
3. Submit necessary documentation – Provide medical records, prescriptions, and any required forms to the supplier.
4. Get approval and delivery – If Medicare approves your request, your supplier will deliver the bed and handle billing.

Medicare Advantage Plans and Adjustable Bed Coverage

If you have a Medicare Advantage Plan (Part C), your coverage may vary. These plans are offered by private insurers and may cover additional features or models not included in Original Medicare.

Key differences between Original Medicare and Medicare Advantage include:

• Broader coverage for certain adjustable bed features.
• Different co-pays and out-of-pocket costs depending on your plan.
• Pre-authorization requirements, meaning you must get approval before purchasing.

Conclusion

Medicare does cover adjustable beds, but only under specific conditions. If your doctor determines that an adjustable bed is medically necessary, Medicare Part B can help cover 80% of the cost, leaving you responsible for the remaining 20%. However, coverage is limited to basic hospital-style adjustable beds, excluding premium features like massage or luxury materials.

Ready to Buy? Here is a Budget-Friendly Recommendation for You!

If you’re looking for a cost-effective adjustable bed that meets Medicare’s guidelines or simply want an affordable option, here are three top choices:

Lucid L300 Adjustable Bed Base

A highly rated budget option with wireless remote control, head and foot incline adjustments, and tool-free assembly for convenience.

Blissful Nights e3 Adjustable Bed

Offers affordability without compromising on quality, featuring a quiet motor, zero gravity positioning, and USB charging ports.

Classic Brands Adjustable Comfort Bed Base

A durable and cost-effective option with multiple ergonomic positions, a user-friendly remote, and a sturdy steel frame.

FAQs

Does Medicare cover all types of adjustable beds?

No, Medicare only covers hospital-style adjustable beds classified as durable medical equipment (DME). Luxury models with massage functions, memory foam mattresses, or smart technology are not covered unless deemed medically necessary.

How do I prove medical necessity for an adjustable bed?

To qualify for Medicare coverage, your doctor must provide a written prescription stating that an adjustable bed is required for your medical condition. Common reasons include:

• Severe arthritis or joint pain
• Respiratory conditions requiring elevated sleeping positions
• Recovery from surgery or injury requiring frequent repositioning

Can I get a fully electric adjustable bed covered by Medicare?

Medicare typically covers semi-electric beds, which allow for height adjustment with a manual crank but have motorized controls for head and foot positioning. Fully electric beds may be covered only if a doctor deems them necessary.

Does Medicare cover the mattress for an adjustable bed?

Medicare does not cover regular mattresses. However, it may cover special pressure-relieving mattresses for individuals with conditions like bedsores or spinal injuries.

Can I rent an adjustable bed instead of buying one?

Yes, Medicare often rents durable medical equipment (DME) instead of purchasing it outright. If you qualify, Medicare will cover the rental costs for up to 13 months, after which you may own the bed.

What is the difference between Medicare and Medicare Advantage coverage for adjustable beds?

• Original Medicare (Part B) covers basic hospital-style adjustable beds under strict eligibility rules.
• Medicare Advantage (Part C) plans, offered by private insurers, may provide broader coverage, including extra features or models. Coverage details vary, so check with your provider.

Where can I find a Medicare-approved supplier for adjustable beds?

You can search for Medicare-approved durable medical equipment (DME) suppliers using the Medicare Supplier Directory on the official Medicare website. Always confirm that the supplier is enrolled in Medicare before purchasing.