Medicare might cover the costs of your next mattress. This may sound a little odd, but there is a good reason to it. See how below:
Medicare is well known for helping to pay for the medical care and needs of seniors in the US. In addition to doctors fees, hospitalization costs, lab work costs and related medical costs; Medicare can also help pay for equipment that is considered medically essential for the patient.
Basic Medicare coverage is provided by what’s called Part A and Part B. “A” covers major medical costs such as hospital expenses, while “B” covers medical expenses such as doctor fees and lab work. Part B also covers certain types of equipment for the patient to use at home, provided it meets the requirements of being classified as Durable Medical Equipment (DME).
Durable Medical Equipment (DME)
For an item to be classified as DME and thus eligible for Medicare coverage, it must meet the following requirements:
– It must be considered a medical necessity and prescribed by a medical doctor, who is an approved Medicare physician.
– The item must be durable, meaning its life expectancy is three years or longer.
– The prescription request must be made within six months of the patient being personally examined by the doctor.
– The request to Medicare must contain documentation proving the medical necessity.
– Medicare will only cover DME that is obtained through an authorized Medicare DME supplier.
Medical Beds
For a bed to be considered as DME, it must be what is usually called a “hospital bed”. This kind of bed is designed for medical care and not for comfort. These types of beds are adjustable, where adjusting the angle and height of both the head and feet is possible. On some models, the height of the mattress off the floor is also adjustable.
Depending on the patient’s condition, Medicare will cover such a bed that is controlled by hand crank(s) or hand-held controlled electric motors. Usually, Medicare will not cover a fully electric motor hospital bed. Extra large or wide beds can be covered for very obese patients.
Medical Mattresses
For a medical mattress to be covered by Medicare, it also must meet all the criteria of being classified as DME. Again, the design and purpose must be for medical care, not just comfort. Basically, the only type of medical mattress that will be covered by Medicare is a “pressure-reducing” mattress. These are designed to alleviate pain and promote healing.
The following pressure-reducing mattresses are highly rated:
– Joerns PrevaMatt Defend Pressure Relief Mattress
– Solace Resolution Glissando Heavy Duty Mattress
– Therapeutic 5-Zone Support Mattress
– ThevoRelief Pressure Relief Mattress
Special Considerations
Medicare will cover 80% of the cost of an approved DME item, the patient must pay the remaining 20% out of pocket.
There is a supplemental Medicare insurance policy called Medicare Advantage, available through private insurance companies. These policies may provide for more liberal and broader coverage for DME items than Part B.
A requirement that DME be for home use can be satisfied even if the patient is in a care facility or at a relative’s home.
For a DME to be covered, even a medical mattress, it must be obtained only through an authorized DME supplier.
