If you are a senior citizen or have a family member who is, then you know how important it is to maintain independence and mobility. Lift chairs are a great option for those who need a little extra help getting in and out of their chairs.
Lift chairs are a type of recliner that has a built-in motor that helps to raise and lower the chair so that the person can easily stand and sit. They are available in a variety of styles and can be customized to fit the needs of the individual.
If you are interested in buying a lift chair but wondering does medicare pay for lift chairs then this blog has the answer for you.
In this blog, we will cover whether a lift chair is eligible for claim under medicare or health insurance and what is the process to claim it.
If you are planning to buy a lift chair for yourself or a senior member in the house then you must know whether medicare pays for lift chairs for seniors.
Fact Check Does Medicare Pay for Lift Chairs for Seniors
We checked the Medicare Documentation and Medicare Part-B Which is the Medical Insurance that covers
- A few types of Doctor’s Services,
- Outpatient Care
- Medical Supplies
- Durable Medical Equipment
- Preventive Services
The Durable Medical Equipment (DME) consists of patient lifts like Lift Hospital Bed, Lift chairs, etc. Your Medicare will pay 80% of the equipment upon approval and the rest 20% has to be borne by the insurer.
The amount Medicare will pay for the lift chair may be less than the cost of the supplier so there can be more out-of-pocket costs for you.
Medicare can pay for the Lift chair in 3 different ways
- A lift chair on Rent
- Buy the lift chair
- Choose between Buying or renting the lift chair
But in order to be eligible for Medicare pay for the lift chair there are a few conditions that should be met,
- The first condition is that the Medical Supplier of the lift chair and the doctor prescribing the lift chair should be enrolled in Medicare. If they are not enrolled medicare won’t pay anything.
- At the time of prescribing or buying the lift chair, the Doctor and DME supplier should have an active enrollment in medicare. Without active registration they can not participate in the assignment and Medicare will not pay for the lift chair.
- If they are enrolled they must participate in the medicare assignments. If they are enrolled but not participating then medicare won’t pay.
If your DME Supplier is enrolled and participates in the assignment then it can charge you the Co-insurance plus the approved part-B deductible amount which is approximately 20% of the cost of a lift chair. The remaining 80% will be borne by Medicare.
How Do You Find Enrolled DME Suppliers for Lift Chairs?
If you are wondering how to find DME suppliers that are enrolled in Medicare and accept assignments then you can find them below.
- Just head over to the below link of Durable Medical Equipment Suppliers.
- Now enter your zip code and under the equipment type you can type Seat lift Mechanism or you can find it from the list and select it.
- It will automatically find the DME suppliers that are enrolled in medicare and supply lift chairs.
- Now you can order your list char from the supplier by paying your share of the lift chair which is approximately 20% of the lift chair cost.
There are 2 major benefits of buying from these enrolled supplies,
- The supplier has met the eligibility requirements to supply lift chairs and bill medicare, So you don’t have to take the hassle of claiming.
- The supplier accepts the Medicare-approved amount, meaning you only have to pay the medicare deductible plus the coinsurance amount.
What are the Requirements for Claiming a Lift Chair under Medicare?
If you have Medicare coverage and qualify, Medicare will reimburse you for the cost of the lift mechanism inside the chair. This is approximately $300 depending on which Medicare region you’re in. Approximately 80% of customers buying lift chairs file for reimbursement.
Only the seat lift mechanism on a lift chair could be considered medically necessary if all of the following coverage criteria are met:
- The patient must have severe arthritis of the hip or knee or have severe neuromuscular disease.
- The seat lift mechanism must be a part of the physician’s course of treatment and be prescribed to effect improvement, or arrest or retard deterioration in the patient’s condition.
- The patient must be completely incapable of standing up from a regular armchair or any chair in their home.
(The fact that a patient has difficulty or is even incapable of getting up from a chair, particularly a low chair, is not sufficient justification for a seat lift mechanism. Almost all patients who can ambulate can get out of an ordinary chair if the seat height is appropriate and the chair has arms.) Once standing, the patient must have the ability to ambulate (walk).
- Coverage of seat lift mechanisms is limited to those types which operate smoothly, can be controlled by the patient, and effectively assist a patient in standing up and sitting down without other assistance.
- Excluded from coverage is the type of lift that operates by a spring release mechanism with a sudden, catapult-like motion and jolts the patient from a seated to a standing position.
- Coverage is limited to the seat lift mechanism, even if it is incorporated into a chair.
How do I file for Medicare Reimbursement?
You will need 3 things to file for your reimbursement:
- A doctor’s prescription
- The bill of sale
- And a Certificate of Medical Necessity (CMN)
The equipment supplier will provide you with the bill of sale. Here is our CMN sample/format for buying Lift Chairs.
Download the CMN Sample copy or Format. (PDF File)
You then take or mail the CMN to your specialist for their completion. Once completed by your doctor, mail the CMN, bill of sale, and the doctor’s prescription to your Medicare regional claims office. If approved, you will receive a check back for reimbursement.
If you have Medicare or private insurance and believe your lift chair should be covered, please read the blog to get expert guidance to obtain the best solution under your insurance coverage.
While Medicare covers the cost of lift chairs but you have to make some out-of-pocket expenses. If you or a loved one is considering a lift chair, be sure to check with Medicare to see what coverage is available.
And, as always, feel free to like and comment on this article if you have any questions or thoughts.