Have questions about Medicare reimbursement for lift chairs? Worry not, we have detailed information on our lift chairs covered by medicare or not.
Lift Chairs are medical equipment that has an inbuilt mechanism for lifting a person from a sitting to standing position. It may look like a recliner but its hydraulic lift system enables people to sit upright, stand, or recline.
Most people who want to buy lift chairs, have the question, are lift chairs covered by medicare? Before we get to that, let’s talk more about lift chairs. Lift chairs help older people who suffer from arthritis, mobility issues, and neuromuscular diseases.
The user can operate this reclining chair by pushing a few buttons. The button remote control enables the person to stand up to perform mundane activities like answering the door, going for a walk, and so forth.
A lift chair is not only for seniors. It is for anyone who has difficulty in moving or faces difficulty in standing up from a seated position. People affected by back pain or stiff joints can also use this chair. People with the following diseases can benefit from a lift chair-
- Parkinsonism – People affected by Parkinson suffer from tremors in hand, stiffness, and difficulty in movement.
- Osteoarthritis – It results in joint stiffness, hip mobility problems, and joint pain.
- Seniors who have chronic fatigue and find it difficult to stand up from a sitting position.
- People who have stiff muscles.
- People who lie down for a long time; as it can reduce bedsores by enabling movement.
- People who have undergone surgery for joint pain. Lift chairs can also be a great option for individuals undergoing joint or hip replacement surgeries, where their mobility is curbed throughout the recovery period.
If a doctor prescribes a lift chair, then medicare will provide part of its expenses.
Medicare reimburses 80 percent of the cost of the motor of the lift chair, and you’ll have to pay for the remaining. The chair must be for medical conditions and not recreational purposes.
Many chairs have additional features like messaging options. Though the features make the product more comfortable, they do not serve the chair’s medical purpose. If you want additional features, you will have to pay for them yourself.
What Is Durable Medical Equipment?
Durable Medical Equipment or DME is medical equipment that lasts long. A doctor prescribes it for a medical reason and is used by someone who has an injury or a disease. DME includes blood sugar monitors, test strips, wheelchairs, and more.
Medicare will pay the motor of the lift chair as it is a DME – durable medical equipment.
However, you will have to pay for the chair while purchasing it. Post that, you will get a reimbursement. For this, you will have to buy it from a supplier that bills Medicare.
So, to get Medicare, the lift chair should be-
- Used for a medical condition
- Used inside your home
- Must provide at least 3-4 years of use
- If your insurance provider has already provided walkers and wheelchairs, then they will not cover the cost of a lift chair.
You can get lift chair Medicare if you meet the following conditions
- You have Medicare Plan B coverage or additional Medicare coverage.
- You live in your own residence. Residents of a nursing facility or hospital facility will not be reimbursed for a lift chair.
- You need a doctor’s prescription so that the company can issue medicare funds for the lift chair. The doctor will evaluate if you have a neuromuscular disease or severe arthritis in knees or hips.
- If you have a disease that limits your ability to move freely, you can avail of this chair.
- Once the lift chair straightens, you should be able to walk on your own but you may take the help of a walker.
- You are unable to sit up from a normal chair on your own but can walk when you stand, by yourself, or with a walker.
- If you use a wheelchair or a wheelchair scooter, Medicare will not cover the lift chair. Using a wheelchair means a person cannot walk without assistance. In this case, a lift chair won’t be much use.
You have tried all possible treatments but to no avail.
If you meet the required conditions, Medicare will cover most of the expenses of a lift chair.
Tips On Buying Lift Chair Under Medicare
Always, buy a lift chair from Medical equipment, not a furniture store. If you are seeking Medicare, buy it from a supplier who is under Medicare.
In medical equipment shops, the lift chair is built around the motor. However, in furniture companies, it is the other way around.
Lift chairs come in different sizes to suit people of shapes, sizes, and height.
If you are buying a lift chair for yourself ask yourself the following questions-
- Who will use the lift chair?
- What is the size of the person?
- How far do you like to recline back your chair?
- Do you have a pet? If you have one, you will need more space in your chair.
- How long do you intend on using it?
- Where will you place the chair? As the chair might take up a large area, is there enough space for it?
- If the person who wants to get a lift chair has dementia, buy a lift chair with minimal controls.
If a person has dementia, opt for lift chairs with a remote having fewer buttons. It makes it easy to control the chair. For a person with dementia, there are dementia phones with an SoS that seniors can use easily.
The motors determine the type of lift chair. Lift chairs with 2 motors are easy to operate. If the patient uses a walker, it should be kept next to the chair. Medicare doesn’t support a chair with a dual motor.
What Are The Lift Chairs That Medicare Supports?
1. Reclining Mechanism
A reclining lift chair enables you to rest in a variety of positions. You can sleep here too. They have elevated footrest. They are similar to a sleeper chair in the extended position. Most lift chairs have a battery backup as it is extremely important for those who can not stand up without assistance.
Medicare only covers lift chairs with a basic lifting mechanism, so it will not provide for a chair with a reclining mechanism. If you use a reclining chair that doesn’t provide limitless positioning, you will still be able to enjoy the benefits of a full reclining lift chair. A built-in lift chair with partial recline results in improved blood circulation too.
2. Heat And Massage
Many lift chairs provide heat and massage and feature a heated backrest. Heat and massage can provide relief and respite to you if you have discomfort in your back. But Medicare does not cover for these features.
Lift chairs are made of leather fabric, polyester, suede, and vinyl. Synthetic leathers are durable and can be wiped easily if spillage occurs. They are scratch-resistant and you can clean them with bleach too. However, authentic leather is the best.
Medicare coverage has no guidelines on lift chair materials. Though you can choose your preferred upholstery, you will have to pay out of your pocket for upgrades.
You can use supplemental plans for buying a lift chair of your own choice. A Medigap policy or a supplementary medical policy may cover additional costs.
Let’s Talk About Medicare-
- Medicare A generally covers inpatient, skilled nursing, and hospice care.
- Medicare part B covers research, durable medical equipment, mental health, and some prescription drugs. You can get coverage if you are covered by Medicare Part B. Medicare Part B is for seniors who have a motor or renal disease. So, Medicare part B pays for the lifting mechanism after you have purchased the lift chair.
- Medicinal Advantage is a private insurance provider’s policy. It is also called Part C. If you have a Medical Advantage you can get the chair if your private insurance company approves.
What Is Medicare Coverage?
- You should have Medicare Plan B or Plan C for availing reimbursement for a lift chair.
- You will need a Certificate of Medical Necessity or Medicare Form CMS
How Can I Get It?
- To get the certificate of medical necessity, you’ll need an in-person appointment with your doctor.
- Your doctor will provide you with a prescription that states you have a disease or impairment that requires a lift chair at home.
- He will have to fill out section B and D of the Certificate of Medical Necessity for Seat Lift mechanism form.
The doctor should be a Medicare-enrolled physician. Medicare will only pay for a lift chair if a doctor prescribes it.
Also, ask the company where you are buying Medicare if they are enrolled for the same. If they aren’t, you may end up paying more than the stipulated amount.
After you complete the paperwork, send it to your provider. The provider should submit the claim for your lift chair. Then you can reimburse the bill.
How Does Reimbursement Work?
When you buy from a supplier who is under the coverage of Medicare, they will file on your behalf. The supplier should be an active participant in Medicare. If they are not, they will charge for your DME on their own.
If the supplier does not file for Medicare, you have to file online within 12 months of the purchase of the lift chair. To submit a claim online, keep these things available-
- A claim form
- The bill of the lift chair
- A letter explaining the reason for the claim
- Supporting documents like doctor’s prescription
How Can You File A Claim?
- Fill in the claim form available on the Medicare website.
- Submit the purchased lift chair.
- Pen down a letter with detailed information on why you are submitting the claim.
- Submit supporting documents
You can also rent a lift chair. Ask the company if they are Medicare providers and if they, they will help you in hiring a list chair.
Choose which one works for you according to your budget.
Medicare will pay for the lift chair as long as you meet the conditions. Your doctor will assess your condition and verify if it falls under Medicare B guidelines.
The doctor must be responsible for the treatment of your condition.
If you have severe arthritis or neuromuscular disease and are covered by Medicare B, it will pay for the lifting mechanism of your lift chair. Medicare Part B will cover 80 percent of your purchase. However, you will have to pay for the remaining amount. If supplemental insurance covers you, then it can cover the additional 20 percent too.
Medicare Supplement Plans
- This includes coverage from a Medicare Supplement Insurance policy or Medigap.
- Part B reducible is the amount left from the amount reimbursed by Medicare.
There are three medicare supplement plans-
- Medicare Supplement Plan F- You don’t have to pay the remaining 20 percent of the cost of your chair or the Part B deductible. Part B deductible is the amount you pay from your account before Medicare coverage begins
- Medicare Supplement Plan G– You’ll have to pay the coinsurance which is the amount left from the cost of the chair and the Part B deductible.
- Medicare Supplement Plan N- You don’t need to pay the 20 percent coinsurance. You will only have to pay the Part B deductible.
Recent Changes To Medicare Advantage
Medicare Advantage is also called ‘all in one’. It provided the benefits included in Plan A, Plan B, and Plan D. This reduces the out of pocket costs that you have to pay. It covers benefits that Medicare doesn’t cover.
In 2019, there was a change in the provision of plans regarding the extended coverage that Medicare Advantage entails. It categorized lift chairs as allowable supplemental health care benefits.
Medicare will cover basic lift chair mechanisms. However, if you buy lift chairs that have features like double motor, heat, and massage, full recline; you’ll have to pay extra charges.
A doctor who is under Medicare will have to certify you. You’ll need his prescription for lift chairs which declares that it is a medical necessity.
Medicare’s Competitive Bidding Programme
If you are buying a lift chair as a Durable Medical Equipment, it may come under Medicare’s bidding program. This program entails the cost of the lift chair on the basis of location.
So, lift chairs are important for pain relief. For senior citizens with mobility issues and joint-related disorders, it is a necessity. It helps them lead a normal life so that they can perform their day to day functions without taking assistance from anyone.
Lift chairs help seniors perform their daily activities without the assistance of anyone else. This instills a sense of independence in them. Since the benefits clearly outweigh the cost considerations, you should buy one. You can also buy the best shower chairs if you are facing problems with hip mobility.
The Medicare cover procedure is simple. Your doctor and lift chair supplier who are under Medicare will help you through it. Fill out the forms and buy the chair that is perfect for you and your mobility issue, and not because of its additional features.
Lift chairs last long, so buying the perfect one is the key. If you have Medicare B coverage, then go through with the procedure and enjoy the benefits of a lift chair.