WILL MEDICARE COVER THE COST OF A LIFT CHAIR?

Having a lift chair is highly important for people that require support and assistance to get into their chair on a daily basis as a result of life changes like aging, surgery linked to mobility, and arthritis.

Sadly, lift chairs don’t come that cheap. They cost so much (between hundreds and thousands of dollars). As a result of this high cost, a lot of Medicare beneficiaries are left to wonder if their health insurance plan can cover all or part of the total cost of their chair.

The truth is that it varies. Typically, it is unusual for Medicare to pay for a lift chair in full but the seat-lift mechanism may be covered by Medicare Part B (Medical Insurance) or Medicare Part C (Medicare Advantage) if the doctor adjudge that it is if medical importance to you or help improve your condition. Under such circumstances, it is usually covered as durable medical equipment (DME).

What exactly is a lift chair?

To start with, it is important to establish the difference between a lift chair and a stair lift which is a type of chair for moving people across the staircase. A lift chair is also very much different from a patient lift which is a device that provides assistance for lifting sick people from one place to another (like from a bed to wheelchair) by their caregivers. A lift chair is comparable to a large comfortable leather or fabric recliner that could be positioned in the living room. The major dichotomy between a lift chair and regular chair is the fact that it features a seat-lift mechanism that alters the back and base of the chair forward so that you can alternate between a standing position or seating position without a need for extra support or assistance.

What is the cost of a wheelchair?

Typically, Medicare insurance usually caters for the cost of the seat-lifting mechanism if it is proven that you qualify for a lift chair. Medicare will likely not cover for the entire cost of the chair. Usually, the reimbursement amount varies across states but it is usually around the $300 mark and you’d have to complete the payment.

Just like other Part B items covered by Medicare, you’d have to make payment for twenty percent of the total cost of the lift chair as approved by Medicare if purchase is made from a supplier that accepts assignment (after paying for the annual deductions).

If you are in Madison Wisconsin, and you cannot afford to buy a wheelchair, you can rent a wheelchair through Madison medical rental

Where can I purchase a lift chair?

It is important to check the Medicare website, Medicare.gov before selecting a supplier. This will help you identify a supplier that accepts assignment, or the amount approved by Medicare as complete payment for the services offered. The website is easy to navigate and identifying a supplier is not difficult. You only have to enter your zip code, choose a category for the seat lift, and using an M symbol, search through the supplier’s directory.

If you have an existing Medicare coverage through the Medicare Advantage Plan, adhere to the instructions and guidelines for your plan for approval and purchase. Your plan’s customer service representative will also be on standby to answer any questions or clear any doubts.

Rent a lift chair in Madison, and in Milwaukee, contact Madison Medical Rental.

How can I qualify for a lift chair?

 A lift chair’s seat-lift mechanism will only be paid for by Medicare if the following conditions are met:

Medicare Coverage: To be eligible, you must possess Medicare Part B (Medical Insurance) or a Medicare Advantage Plan (Part C). Your private insurance provider should be able to guide you and run you through coverage rules, costs, and suppliers to make use of when getting a lift chair (if you are under the Medicare Advantage Plan).

Certificate of medical necessity: A prescription for the lift chair from your physician is needed and it is a requirement. This prescription proves that the lift chair is medically necessary and it helps you complete the Medicare form CMS-849 which is also called the “Certificate of Medical Necessity for Seat Lift Mechanism form.”

Medical necessity is determined by a host of factors such as:

  • The patient is suffering from severe arthritis of the knee or hip, or a severe neuromuscular disease.
  • The patient does not have the capacity or capability to stand up from a regular chair.
  • The course of treatment of the physician includes the seat lift mechanism to enhance the recovery process of the patient.

Medicare-participating suppliers: The lift chair must be ordered from a Medicare-participating supplier that accepts assignment otherwise the cost will not be covered by Medicare.