Since you’re here, I’m guessing you’re interested in getting a hospital bed and probably asking yourself…does medicare cover hospital beds?
Well, the answer is yes and no, depending on certain criteria.
The price tag on a hospital bed can be quite costly, so going through medicare might be the best option for you, but don’t be let down if you don’t qualify because there are less expensive hospital beds on the market. They may not have the same bells and whistles as the more expensive beds, but it will get the job done.
Does Medicare Cover Hospital Beds?
Medicare covers hospital beds if you can show a medical necessity for the hospital bed. You have to be covered under the Medicare Part B and have been properly accessed by a doctor. The doctor must document you need a hospital bed in your medical records and also write an order or prescription for the equipment.
Only a doctor has the ability to prescribe a hospital bed for you. Then the supplier must receive the prescription before the Medicare is billed. It must also be kept on file by the supplier.
Hospital Beds Covered by Medicare
1. Variable height hospital beds
This type of beds is covered if the patients qualifies for the criteria of needing a fixed height bed and also needs a bed height that is dissimilar to a fixed height hospital bed to allow transfers to a wheelchair or chair.
These hospital beds are covered by the Medicare if the patients qualifies the criteria needed for a fixed height hospital bed also needs regular changes in his/her body positions or has an instant need for changing the body position.
3. Heavy duty extra-wide hospital wide
These type of hospital beds are covered if a patient qualifies criteria needed for fixed height hospital beds and he/she weighs above 350 pounds but doesn’t surpass 600 pounds.
4. Extra heavy-duty hospital beds
Extra heavy-duty hospital beds are covered if a patient has qualified one of the criteria needed for fixed height hospital beds and he weights above 600 pounds.
A full electric hospital bed isn’t covered by the hospital bed at all. This is because it is considered as a convenience bed. However, in case insist on having a hospital bed, you are required to pay for the difference between the bed you qualify and the one you insist on using.
This equipment is projected to provide a patient with an effective means of effective self-help in changing the position while in bed. He can also use it to move from his bed to a bedside commode, to move onto a bedpan, or to move to a chair with minimal aid from the attendant.
Bed Side Rail
This is a safety handset that prevents a patient from rolling out of the hospital bed.
The items below are also sold
• Mattress overlay
• Foam wedge
• Protective bed pads
• Fitted sheets
Medicare pays for a lot of money to cater for all costs that are associated with the many kinds of medical items used for home care. Most of the health insurance plans do have quite similar guidelines to Medicare. However, you should keep in mind that all the private insurance plans differ and the specific regulations of your plans can vary from these medical guidelines
How much do you expect to pay?
Every, apart from the monthly premium, you’ll required to pay a fee of $135 of the covered expenses. You’ll be then required to pay 20% of all fees if the equipment provider accepts Medicare payments
Your medical provider can’t automatically ignore this 20% of deductible without accumulating penalties. Your equipment provider should also attempt to gather both the deductible and the coinsurance if those fees aren’t covered by an insurance plane. Fortunately, certain exemptions can be applied if you suffer from financial hardships.
In case you’ve an additional insurance plan, that plan can take after this portion of responsibility after your supplemental insurance plan’s deductible has been met.
Furthermore, if your provider fails to accept requirements with the Medicare, you can be asked to account for the full amount up front, but they can file a claim on behalf of your patient to the Medicare. Medicare processes the claim filed and it will mail you a cheque so that you can cover portions of your costs if the fees are approved.
How does Medicare pay for the equipment?
Typically, there are 4 ways Medicare pay for the covered equipment:
- Purchase the equipment outright and then it belongs to you
- Rent the equipment continuously till it is no longer needed.
- Consider the equipment a capped’ rental in which the Medicare rents the equipment for 13 months and then consider it purchased after making the 13 payments.
- However, you should not that Medicare won’t allow you to buy this equipment outright
- In case you’ve oxygen therapy, Medicare makes rental payments for 36 months during which time this charge covers all service, oxygen contents, and accessories.
Medicare requirements for a hospital bed
Medicare covers a hospital bed when a patient can’t use a normal bed because he needs to:
- Change the body position in a way that isn’t possible in a normal bed
- Use traction equipment which has to be attached to a hospital bed
- Have the head of your bed higher or more than 30 degrees due to illnesses such as chronic pulmonary disease, congestive heart failure, and more others.
- Be in body positions that are not possible in a normal bed so as to relieve pain.
Fixed hospital beds are covered if these criteria are met:
- A patient needs traction equipment that can only be attached to a hospital bed
- A patient needs to position her body in ways that aren’t feasible in an ordinary bed to alleviate pain.
- A patient has a medical condition that cannot be accommodated by a normal bed.
Where to Purchase or Rent Hospital Beds
You’ll save money in case you order your equipment from the Medicare-approved provider which accepts the assignment. You can also purchase a hospital bed from any supplier which sells them. Nonetheless, you should also know that if the retailer from which your order a hospital bed isn’t enrolled/registered in Medicare, Medicare won’t pay for that equipment.
There are 2 kinds of Medicare supplier – that is- the participating supplier, and those that are already enrolled but decided not to participate directly. The participating suppliers often don’t charge more that Medicare allowed amount. Those who don’t want to participate directly can charge a way more than the amount for Medicare-approved. Nevertheless, they can’t charge more than 15% above the amount charged by the Medicare-approved suppliers.
When purchasing or renting a hospital bed, you should know the Medicare guidelines to avoid incurring unnecessary expenses on something that you could have easily avoided.
For more information check out: https://www.medicare.gov