As we get older or deal with health challenges, a good night’s sleep becomes even more important. Adjustable beds can make a big difference in comfort and support, but you might be wondering—does Medicare help cover the cost? At Mair Agency, we’re here to help you navigate your Medicare benefits, so let’s break down what you need to know about Medicare coverage for adjustable beds.
Here’s something you might not know: older adults don’t actually need less sleep than younger adults. In fact, we all need about seven to nine hours of sleep each night, no matter our age. The reason this myth exists is that many older adults face conditions like arthritis, insomnia, anxiety, and depression, which can seriously impact sleep quality. 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 help you find ways to get the rest you deserve!
- You can also learn more about the basics of Medicare by accessing our FREE course below.
WHAT IS THE BENEFIT OF AN ADJUSTABLE BED?
Adjustable beds are a fantastic option for older adults who have trouble with mobility or need to sleep in different positions. They make it easy to adjust the height of the head and feet, as well as the mattress position, offering extra comfort and support. For those dealing with arthritis, joint pain, or muscle spasms, adjustable beds can help 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.
An adjustable bed is also a great option for anyone who has trouble getting out of low-set beds. It’s also super helpful for those recovering from hip surgery or other orthopedic injuries, like broken hips or femurs. By letting you raise your legs higher than a regular bed, it can actually help speed up recovery and make the healing process a bit easier.
DOES MEDICARE PROVIDE COVERAGE FOR ADJUSTABLE BEDS?
The Short Answer: Yes, Under Specific Circumstances
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.
Medicare Part B may cover adjustable beds, but it’s not as simple as wanting a more comfortable sleep setup. To qualify, there must be a demonstrated medical need. Medicare views adjustable beds as Durable Medical Equipment (DME), meaning they must be medically necessary for your condition.
What’s Required for Medicare Coverage?
- Medicare’s Definition of “Medical Necessity”: Medicare needs to see that the bed is essential for your health. For instance, if you have a condition that requires you to sleep with your head elevated, or if you have severe arthritis that makes getting in and out of bed difficult, an adjustable bed might be considered medically necessary.
- Doctor’s Prescription: This is the most critical step. Your doctor must provide a prescription explicitly stating the medical necessity of the adjustable bed for your specific condition. The prescription should detail why an adjustable bed is required, rather than a standard bed.
- Supporting Medical Documentation: You’ll need to provide medical records and a physician’s report that clearly outlines your medical condition and how an adjustable bed will alleviate your symptoms or improve your overall health.
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.)
What Types of Beds Are Covered?
Medicare is more likely to cover basic hospital beds or the components that make a bed adjustable due to a medical condition. This might include:
- Electrically-Powered Beds: To adjust the position of the bed.
- Adjustable Heights: If you need assistance getting in and out of bed.
- Side Rails: For safety and support.
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)
Mair Agency is Here to Help
Navigating Medicare can be complex, but you don’t have to do it alone. At Mair Agency, we’re committed to providing clear, helpful information and guidance. If you have questions about Medicare coverage for adjustable beds or any other Medicare-related concerns, please don’t hesitate to contact us. We’re here to help you get the support and care you deserve.
