In case you can prove the necessity for the bed in your recovering process, Medicare will cover for it. Besides, you have to be covered under Medicare Part B and you must have been assessed by a doctor. The doctor should have your need documented in your medical records as well as writing you a prescription for the equipment. Your doctor is the only person who can prescribe a hospital bed for you.
The hospital bed supplier has to receive an order before billing the Medicare and it should be recorded on file by the supplier.
What should I do to qualify for a hospital bed?
In order to have the qualifications for the hospital bed, you have to prove the following:
- Changing different positions is impossible on an ordinary bed.
- To lay or sleep in positions is impossible with the ordinary bed as it leads to pain.
- Your head needs to be higher than 30 degrees in order to sleep due to health issues such as congestive heart failure, respiratory problems, and many other problems.
- You have to use traction equipment that must be attached upon the hospital bed.
- You must have a medical necessity certificate that is filled, signed and dated by your doctor.
If you have all the above-mentioned criteria, then you are eligible for having Medicare cover for your hospital bed. There are different kinds of beds which include the adjustable hospital beds. Each type has its own additional criteria for being covered by Medicare. Your doctor, as well as the supplier, will determine what do they need to document according to your needs so as to qualify for having the bed as well as the equipment that will full fill your needs. There are different kinds of beds such as the adjustable beds, full electric beds, semi-electric beds as well as the electric hi-lo beds that are ideal for devices, and these are no covered by Medicare.
What is the cost of renting or buying a hospital bed?
As soon as you pay your pay tour annual deductible, you will then be required to pay 20% of the total price of a particular hospital bed that you need to buy or rent. Medicare will cover the remaining 80% but in case you have supplemental insurance you might pay even less. Besides the supplemental insurance might prevent you from paying anything out of your pocket for a manual crank, or a semi electrical bed.
The cost might be so high in case the supplier does not accept the assignment. The hospital beds are categorized in the Capped Rental group. This means that you can choose to rent or purchase the bed. As soon as Medicare has paid for 10 months’ rental fees, you will be offered an opportunity to purchase it. Your supplier will send a purchase option in the 9th month of your rental and you will have only 30 days of replying.
In case you reply accepting to buy the bed this is what will happen:
- Medicare will have to make three more payment and automatically the bed will be yours.
- You will have to cover the maintenance costs although Medicare might also cover some of them.
In case you do not reply to the letter or decide that you need to continue renting, this is what will happen:
- Medicare will continue paying the rental fees until the total rental payments reach 15 times and the bed will be yours as long as you still need it.
- The supplier will keep the bed ownership and will be responsible for making sure that it is maintained.
- You might be charged the maintenance and service fee every six months.
Where can I purchase or rent a hospital bed?
It will be in your best interest if you purchase your items from an Approved-Medicare provider who accepts the assignment. This will save you a lot of money. Besides you can still purchase your hospital bed from different stores that deal with hospital equipment. But remember in case the supplier from which your order is not enrolled in Medicare, Medicare will not cover the cost of the equipment.
What are the things that you must consider before choosing your supplier?
- Generally, Medicare suppliers can be categorized into two types which are the participating suppliers, as well as those who are enrolled in Medicare but have opted for not participating.
- The participating Medicare suppliers will never charger more than what is allowed by Medicare.
- A Medicare-approved supplier who opted not to participate is allowed to charge more than the Medicare-approved amount. But they are not allowed to exceed 15% than the approved Medicare amount. Besides they can ask you to cover for the entire bill when you pick up your hospital bed. In such a situation the Medicare will deliver the reimbursement directly to you. But keep in mind you might have to wait for a long time before you can receive your payment.
- In case you receive your Medicare coverage via a Medicare Advantage Plan such as the HMO or PPO, normally this plan has its steps when it comes to purchasing. Besides the plan consists of restrictions about the suppliers that you can use.
Does Medicare cover for electric hospital beds?
Full electric beds are not covered by Medicare. This is due to the fact that these are considered convenience devices. But you can apply the cost of purchasing a manual lift upon the purchase price of a full electric type using an Advance Beneficiary Notice (ABN). This will need you to cover the difference between the two equipment. Sometimes it might be cheaper in case you purchase the electric bed directly from the medical supply store.