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Does Medicare cover lift chairs?

Detail Of Senior Woman Sitting On Stair Lift At Home To Help Mobility

Just the Essentials…

  • A lift chair is a chair designed to help a person go from a sitting position to a standing position with the assistance of an electrical lift mechanism. Think of it as a reverse recliner.

  • Medicare will usually cover at least some of the costs for most durable medical equipment, including lift chairs.

  • In order to ensure coverage, a lift chair must be prescribed by your doctor and ordered from a Medicare-approved supplier.

  • Medicare Advantage beneficiaries may receive more coverage for DME devices like lift chairs, depending on their exact plan.

What is a lift chair?

A lift chair, also known as a seat lift chair or lift assist chair, is a chair designed to help someone get onto their feet from a seated position. In most cases, a lift chair usually resembles a typical recliner or armchair, and it is usually capable of reclining to a lying position electronically as well.

A lift chair lowers or lifts on an inclined angle that is intended to make it easier for you to get to your feet after sitting or laying for a long period of time. This movement usually occurs at the push of an electronic button.

There are many upgradable features to a lift chair, including its level of cushion, its upholstery design, and its frame size. Because these elements are not considered essential to the medical purpose of the chair, they are not usually covered by Original Medicare.

Please note that a lift chair is not the same thing as a stair lift, which is designed to help seniors and disabled individuals ascend to different floor levels within their home. It is also not the same device as a patient lift, which is designed to assist caregivers in moving someone from a bed or chair onto a wheelchair or vice versa.

Does Medicare pay for lift chairs?

You may be pleased to learn that Medicare will provide at least some level of coverage for the cost of an electric lift chair. However, because this coverage falls under Medicare Part B, it applies only if the chair has been formally prescribed by a medical doctor.

It’s also important to note that Medicare will not always cover the entire cost of a lift chair, only a portion. This is because only the motorized lift mechanism is considered to be durable medical equipment under current Medicare law.

The other parts of the chair, such as the cushion, frame, and upholstery, can be tailored for additional comfort. As a result, these parts are not currently covered under Medicare Part B.

What is the cost of a lift chair under Medicare Part B?

In order to receive coverage for your lift chair, you must first meet your plan’s deductible. If you do meet this deductible, you will pay 20 percent of the cost of the Medicare-approved chair-lifting mechanism out-of-pocket. Medicare Part B will pay the rest. Remember that you are 100 percent responsible for paying for the other parts of the chair, including cushions and upholstery.

Can I be reimbursed for my lift chair?

If you decide to buy a lift chair from a Medicare-approved supplier, you will likely pay for the total cost of the chair up front, and then be partially reimbursed by Medicare Part B later.

As long as your supplier is enrolled in Medicare, they will usually file a claim on your behalf. If they do not, you will need the following items to file the claim yourself:

  • The claim form
  • An itemized bill
  • A letter explaining the reason for submitting the claim
  • Any supporting documents related to the claim, like your prescription.

What is the criteria for a device to be considered Durable Medical Equipment?

In order for a device to be considered eligible for Medicare coverage, it must meet specific criteria. Firstly, Medicare will only provide coverage for durable medical equipment (DME) if your doctor prescribes the equipment to you for a medical reason AND your doctor and DME suppliers are enrolled in Medicare.

When you search for a lift chair or lift chair installation, it’s important to ask the company if they are enrolled in Medicare and accept assignment. If the chair company doesn’t participate in Medicare, you may be charged more than the accepted Medicare amount, and it will be your responsibility to cover the difference.

In addition to the above criteria, the following criteria must be met in order to receive coverage for DME through Medicare:

  • The equipment must be durable (i.e. intended for repeated use)
  • The equipment is intended for at-home use
  • The equipment is intended to last at least three years
  • The equipment is intended for use by someone who is ill or disabled

In addition to electric lift chairs, other examples of DME include crutches, wheelchairs, and walkers.

Woman stands with disabled elderly mother in front of lift chair

How can I become eligible for DME coverage under Medicare?

You can be considered eligible for Medicare coverage for DME equipment like lift assist chairs as long as you are enrolled in Medicare Part B. To be eligible for Medicare, you must have attained the age of 65 years old, or qualify for Medicare coverage as a result of debilitating disease or disability such as end stage renal disease or ALS (amyotrophic lateral sclerosis).

In order to be covered for an electric lift chair at all, you must first be evaluated by a doctor and obtain a prescription for the device. The following elements will be considered by your doctor before they decide whether to prescribe a lift chair to you:

  • The degree to which you are affected by conditions like arthritis, especially on your knees and hips
  • Your ability to operate a lift chair
  • Your ability to rise from the chair without assistance
  • Your ability to walk after the chair has lifted you, either under your own power or with the assistance of a walker
  • You have exhausted other methods of treatment, such as physical therapy, in order to regain your ability to go from sitting to standing without assistance

What about coverage through Medicare Advantage?

If you currently have coverage under Medicare Advantage (Medicare Part C), you are likely still eligible for lift chair coverage, despite the fact that these plans are offered by private insurance companies.

In fact, because Medicare Advantage plans often cover additional healthcare needs beyond what is covered by Original Medicare, you may find that you could potentially receive additional benefits

At MedicareInsurance.com, our licensed insurance experts are here to help you research and compare Medicare plans in your area in an effort to help you find the best possible coverage for your needs and lifestyle. Contact us today to get started!

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