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Does Medicare pay for patient ceiling lifts?

2 answers | Last updated: Oct 29, 2013
ggooden asked...
Does Medicare pay for patient ceiling lifts? A statement of medical necessity has been obtained from the doctor.
 

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

Medicare Part Bcovers medical equipment that includes "patient lifts" -- mechanical or hydraulic devices that help to safely lift a person out of or into a bed or chair. See also:
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See all 646 questions about Medicare, Medicaid and Medigap
These lifts are intended to avoid injuries to patients and caregivers alike. For Medicare to pay for the lift, it must be prescribed by a doctor and the doctor must file a "Certificate of Medical Necessity" with Medicare. Before you rent or buy a lift, that certificate must be received and accepted by Medicare. Also, be aware that Medicare will not necessarily approve any lift. It must be a type of life approved by Medicare and carried by a Medicare-certified supplier of durable medical equipment.

Once you have approval for the lift from Medicare, you must get it from a supplier that is certified by Medicare. You can go on the Medicare web site to find certified medical equipment dealers near you. Or you can call Medicare toll-free at 1-800-633-4227. It's also important to get the equipment from a supplier who is a "participating supplier." These suppliers will not charge more for equipment than the amount approved by Medicare. If Medicare covers the lift, it will pay 80 percent of this Medicare-approved amount. The Medicare beneficiary, or the beneficiary's Medigap supplemental insurance policy, pays a coinsurance amount of 20 percent. (WARNING: If you get the equipment from a supplier who is certified by Medicare but who is not a "participating supplier," the supplier can charge you as much as it wants above the Medicare-approved amount.)

To see further detail about Medicare coverage for durable medical equipment, you can go online and look at Medicare's official booklet called Medicare Coverage of Durable Medical Equipment and Other Devices.

 

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Jeff Sirko answered...

Mr Matthews answer is technically correct except that medicare makes distinctions between the many varieties of "patient lifts" they cover. Medicare only covers the hydraulic floor based patient lifts.(ignoring seat lifts for simplicity). They will not cover ceiling mounted or portable overhead patient lifts that you are referring to. Such items are considered a medical convenience, a most absurd and disingenuous term in my opinion,by Medicare. The rest of process outlined is accurate.

A note on non-participating providers: In some product categories you can get a greater percentage of costs covered by Medicare with a participating provider. This is because a participating provider agrees to accept only Medicare's approved rate. However you will often find you get the least expensive item that provider can find to meet the requirements. This item may not be adequate to fit your unique needs. For example a non-participating provider may be able to provide a powered patient lift by charging you the difference between the covered hydraulic (non-powered) lift and the normal powered lift cost. The power features in this case are an upgrade and only with a non-participating provider can you get some coverage from Medicare.

 

 
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