After you meet the Part B deductible you pay 20% of the Medicare-approved amount (if your supplier accepts assignment). Medicare pays for different kinds of DME in different ways. Depending on the type of equipment:
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Make sure your doctors and DME suppliers are enrolled in Medicare. It&#;s also important to ask a supplier if they participate in Medicare before you get DME. If suppliers are participating in Medicare, they must accept assignment (which means, they can charge you only the coinsurance and Part B deductible for the Medicare&#;approved amount). If suppliers aren&#;t participating and don&#;t accept assignment, you may have to pay for the full cost of the DME.
Contrary to popular belief, older individuals do not require less sleep than other adults. Adults of any age require roughly seven to nine hours of sleep each night.
The misconception stems from the fact that many older adults develop conditions that impact the quality of their sleep. Common conditions like arthritis, insomnia, anxiety, and depression all disrupt our natural sleep patterns.
Adjustable beds are a great option to help position the body for a better night&#;s rest. If so many older adults could use one, are these part of Medicare&#;s benefits? Let&#;s find out.
You can also learn more about the basics of Medicare by accessing our FREE course below.
Adjustable beds are a great option for older adults that struggle with mobility and need to sleep in different positions. The adjustable bed allows them to adjust the height of their head and feet, as well as the mattress position. This is beneficial for those who suffer from arthritis, joint pain, or muscle spasms because it reduces pressure on their joints. Raising the top portion of the bed will also reduce snoring by increasing airflow and prevent acid reflux by elevating the head.
The adjustable bed can also be used by people who have difficulty getting out of low-set beds. It can also be helpful to those recovering from hip surgery or other orthopedic surgeries and injuries like broken hips and femurs because they allow you to raise your legs higher than a regular bed does, which speeds up recovery time.
Yes! Original Medicare does offer coverage for adjustable beds as part of a beneficiary&#;s Part B benefits. Part B offers coverage on durable medical equipment (DME), which includes adjustable beds. Medicare will pay for 80% of the cost of an adjustable bed after you have met your Part B deductible.
This does not apply to just any bed on the market, and there are requirements that must be met. Let&#;s talk about those next.
First and foremost, you must have a prescription from your doctor that says an adjustable bed is recommended for your medical health. You cannot simply decide you would like one, purchase it, and expect to be reimbursed by Medicare.
For coverage to be considered, you must meet the following requirements:
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&#; Have a condition that requires special positioning;
&#; Have a prescription from your doctor that includes a narrative explaining the medical necessity of an adjustable bed;
&#; Have medical records that support the narrative of medical necessity; AND
&#; Have a physician&#;s report that further details the medical condition requiring an adjustable bed.
Your doctor may recommend an adjustable bed to treat body pains, cardiac diseases, chronic pulmonary obstructive disease (COPD), quadriplegia or paraplegia (spinal cord injuries), severe arthritis, or other injuries.
For Medicare coverage to apply, the bed must be purchased from a supplier that accepts Medicare assignments. Also, you may be offered the option to either rent or purchase the bed. (Or Medicare may dictate one or the other based on your condition.)
As a general rule, Medicare Part B will cover basic hospital beds. However, additional items may also be covered if your doctor says that they are medically necessary.
Beds with adjustable heights, side rails, and electrically-powered beds are not part of Medicare&#;s basic coverage. If your doctor includes these in the prescription, Medicare may at least pay a portion of the cost.
There are quite a few beds and bedding extras that also fall into the durable medical equipment category. As long they are considered medically necessary, you may get full or partial coverage under Medicare Part B.
These extras include things like:
&#; Mattress pads of various kinds
&#; Air-fluidized beds
&#; Air, water, or dry pressure pads for regular mattresses
&#; Extra-wide, heavy-duty hospital beds (weight capacities are 350 to 600 pounds)
It is unlikely that Medicare will cover the latest and greatest beds, which includes Sleep Number beds. Of course, individuals have the option to purchase an adjustable bed outside of Medicare&#;s coverage.
Whether you need an adjustable bed to help with a temporary injury or require one for long-term use, there is a good chance that you&#;ll be able to utilize your Medicare benefits. Consult with your doctor to find out if you qualify.
Don&#;t forget that you can access our FREE Medicare course by clicking the button below. See you inside!
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