If you’re aging in place at home or have significant mobility issues, you’ve likely given some thought to having a power lift chair in your home. These types of lift chairs can assist you in getting from a sitting to a standing position while minimizing the risk of accidents, such as falls. However, like many types of medical equipment or mobility products, you may be worried about the cost.
Those over the age of 65 and those deemed disabled are eligible for Medicare, but sometimes Medicare coverage can be lacking. If you’ve been wondering the question, “can Medicare help fund residential lift chairs?,” the answer is—somewhat. Read on to learn more about lift chairs covered by Medicare, and what it takes to get a Medicare-approved lift chair.
Can Medicare Help Fund Residential Lift Chairs? DME Explained
If you’re wondering, “can Medicare help fund residential lift chairs?,” the keyword here is help. Unfortunately, Medicare will not cover the entire cost of the chair, only certain parts. Also, you will have to meet certain criteria with Medicare and your doctor to get the best lift chairs covered by Medicare. Medicare only covers the DME portion of the chair.
This may be confusing if you’re wondering, “will Medicare pay for a lift chair?” DME stands for “durable medical equipment.” The only part of the chair that is considered a DME is the motorized lifting mechanism in the chair. Medicare may cover the cost of the DME for you, but you’ll have to meet other criteria and pay for the upholstery, frame, and cushioning of the chair out of pocket. So the answer to, “can Medicare help fund residential lift chairs?,” is yes.
If you ask, “does Medicare pay for lift chairs?,” the answer is no, not completely. Other DMEs that Medicare may cover for you include walkers, wheelchairs, and crutches, among other mobility aids.
Can Medicare Help Fund Residential Lift Chairs? Criteria to Have the DME Covered
Medicare will only cover the DME (motor) of lift chairs if you meet certain criteria. One of the most important things will come from your doctor, and it is called a Certificate of Medical Necessity for Seat Lift Mechanisms form. It is also known as Medicare form CMS-849. Your doctor must complete this form, claiming that the chair is medically necessary for you.
Some of the qualifying conditions include arthritis and mobility problems. In addition, those who transfer from the power recliner from a wheelchair are ineligible. You must be able to stand independently or with a walker or cane. You must also demonstrate the ability to stand up from a regular chair. So as you can see, the question, “can Medicare help fund residential lift chairs?” is a complicated one.
Can Medicare Help Fund Residential Lift Chairs? Types of Medicare
In addition to your medical certificate and physical requirements, you must also:
- Carry Medicare Part B (full medical insurance), or
- Carry Medicare Part C (Medicare Advantage plan)
- Medicare Part A (hospital insurance) will not cover any portion of the lift chair
- If you use Medicare Part B, you must meet your deductible before the DME is covered
Medicare will cover 80 percent of the DME (mechanism), and you are responsible for the other 20 percent. Remember, you are also responsible for 100 percent of the rest of the cost of the chair. The complete answer to, “can Medicare help fund residential lift chairs?,” is 80 percent of the DME once all other criteria are met.
Also, the doctor that signs your certification must be a Medicare provider. The chair company that you are purchasing the chair from must also participate with Medicare. Typically, you will pay for the chair completely up front and ask Medicare for reimbursement. You will need:
- The claim form (accessible via the Medicare website)
- An itemized bill of the chair
- Documentation, such as the medical certificate
- A letter from you explaining the claim submission
If you have Medicaid, they may cover some remaining costs of the chair. However, every state’s Medicaid program is slightly different. Also, Medigap plans may help you with copayments.
If you still have questions about “can Medicare help fund residential lift chairs?” or would like to hear more about power recliners or other mobility products, such as stairlifts and wheelchair ramps, contact Williams Lift Co. today. Although we are not Medicare providers, we want to help both caregivers and their loved ones to live their best lives possible.