Does Medicare pay for hospital beds for home use?

3 answers | Last updated: Apr 12, 2014
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An anonymous caregiver asked...
Will Medicare pay for a home hospital bed for an elderly person?
 

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Caring.com User - Joseph L.  Matthews
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Joseph L. Matthews is a Caring.com Expert, an attorney, and the author of Long-Term Care: How to Plan & Pay for It and...
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answered...

Yes, Medicare Part B See also:
Can you use benefits from VA and Medicare coverage in conjunction?
can help pay for a hospital bed and other "durable medical equipment." For Medicare to cover it, an item of equipment must be "medically necessary" and prescribed by a doctor, and it must be supplied by a medical equipment provider who is officially approved by Medicare. If it covers the bed, Medicare will pay 80 percent of its "approved" amount for its rental (after the patient meets the yearly Part B deductible of $135); the patient must pay the other 20 percent, either out-of-pocket or through Medigap or other insurance.

If the medical equipment supplier accepts "assignment" of the Medicare approved amount for the bed, it can charge the patient no more than 20 percent of that approved amount. However, if the supplier does not accept assignment, it can charge whatever it wants beyond the Medicare approved amount. So, before ordering a hospital bed, ask not only if the supplier is enrolled in Medicare but also if they are a Medicare "participating" supplier. A participating supplier is required to accept assignment of the Medicare-approved amount. A supplier that is enrolled in Medicare, but isn't "participating," might accept assignment but isn't required to. If you are considering using a supplier who is not "participating," ask ahead of time if they will accept assignment for your claim. If not, look for another supplier.

<o:p>To find suppliers who accept assignment, go to the Medicare Suppliers Directory on the official Medicare web site. Or, you can call 1-800-MEDICARE (1-800-633-4227). To find out more about Medicare coverage of durable medical equipment, you can look at Medicare's publication Medicare Coverage of Durable Medical Equipment and Other Devices.</o:p>

Editor's Note: The dollar amounts noted above may have changed. For the most recent information, please check Medicare.gov's page about hospital beds.

 

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navsari answered...

It's great information. But I need info for hospital electric bed for home use. Does Blue cross/blue shield of Florida state employee plan cover any of the cost for it? Thanks.

 

Nurse Jane answered...

Most insurance follows Medicare guidelines. Medicare has recently significantly reduced patients' ability to get hospital beds and wheelchairs. In the western region (Region D) of the US, the Medicare denial rate of randomly reviewed claims is 90% Denial for hospital beds and 96% Denial for wheelchairs. The rules are complex and specific. Physicians are not trained to complete the medical record in a way that will prevent these denials. And soon, this will be worse. Medicare is requiring that patients have a face-to-face appointment with their physician to get this equipment. When the patient is bed-bound and at home, it will be virtually impossible for them to get the equipment they need. So, beware, your past expectations for benefits from your insurance and Medicare have been essentially taken away. There is beginning to be a basic lack of access to care!

 

 
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