Medicare covers different types of durable medical equipment (DME), which may include an adjustable bed if a person meets the criteria.
For people with certain medical conditions, such as a broken hip or paraplegia, an adjustable bed can mean greater comfort and a lower risk of further injury.
This article looks at Medicare coverage requirements. It also examines the costs and financial assistance.
Glossary of Medicare terms
We may use a few terms in this article that can be helpful to understand when selecting the best insurance plan:
- Out-of-pocket costs: An out-of-pocket cost is the amount a person must pay for medical care when Medicare does not pay the total cost or offer coverage. These costs can include deductibles, coinsurance, copayments, and premiums.
- Deductible: This is an annual amount a person must spend out of pocket within a certain period before an insurer starts to fund their treatments.
- Coinsurance: This is the percentage of treatment costs that a person must self-fund. For Medicare Part B, this is 20%.
- Copayment: This is a fixed dollar amount a person with insurance pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.
![Closeup of a person adjusting a bed.](http://i0.wp.com/post.medicalnewstoday.com/wp-content/uploads/sites/3/2020/11/Adjustable_beds_GettyImages1087341436_Header-1024x575.jpg?w=1155&h=1528)
Medicare considers prescribed adjustable beds, including hospital beds, as DME. Therefore, it may cover the cost as long as a doctor certifies that a person needs the bed for home use.
However, there are different types of adjustable beds, and Medicare does not cover them all. For Medicare to consider an adjustable bed as DME, the bed must:
- be durable enough to withstand repeated use
- have a medical purpose
- be for use in a person’s home
- have an expected lifetime of at least 3 years
In general, doctors do not consider an adjustable bed useful or necessary for a person who is not sick or injured. According to Medicare’s definitions, lounge beds — whether they use manual or electric power — are not DME.
Medicare divides its coverage into parts, with each part offering coverage for different aspects of healthcare.
Medicare Part B pays for DME, including adjustable beds.
Part B also covers some medical testing and some medications, such as infusions or vaccinations.
Learn more about Medicare Part B.
Medicare will only consider an adjustable bed as DME if it adjusts either from the head or foot, allowing a person to elevate different body parts as necessary.
The bed should also have side rails that an individual can lower or raise.
Medicare may cover part of the cost for necessary modifications to a person’s adjustable bed, such as having an air-fluidized bed for reducing pressure. Other Medicare-covered adjustments may include:
- electric power adjustments
- extra-wide hospital beds
- gel or gel-like pressure mattress pads
- lambswool or sheepskin pads
For someone to be eligible for an adjustable bed that qualifies as DME, their doctor must write a prescription stating that the bed is medically necessary.
According to the eligibility requirements, the bed is a medical necessity if a person needs:
- positioning to relieve pain or promote body alignment
- positioning in a way that improves respiratory function
- special attachments, such as traction devices, that cannot attach to a traditional bed
In the prescription, the doctor must describe the person’s condition and diagnosis to explain why the adjustable bed is medically necessary.
Examples of conditions for which people may need an adjustable bed include:
- chronic obstructive pulmonary disease (COPD)
- paraplegia
- severe injuries to the legs
- severe cardiac conditions
- severe arthritis
- hip fractures
Although Medicare helps pay for adjustable beds, a person is usually still responsible for paying a portion of the costs. Various factors can also affect the costs, such as the type of bed and the rental or purchase terms.
Purchase or rental
The person must rent or buy the bed from a supplier that accepts Medicare assignment. This means the supplier agrees to the price Medicare sets for renting or purchasing the equipment.
If someone purchases or rents a bed from a supplier that does not accept Medicare, that supplier may charge more than the Medicare-approved amount, and Medicare will not cover the cost.
If a person rents the bed, Medicare covers the monthly payments, and the supplier covers the cost of repairs. Medicare will cover the rental costs for 13 months of continuous use. After this time, the supplier must transfer ownership to the user.
To find a supplier, a person can use Medicare’s online tool or call 1-800-MEDICARE (1-800-633-4227).
Types of bed
Many different adjustable beds are available, with various options for purchase or rental.
Cost factors will include:
- the model of the bed, including whether it is electric or manual
- inclusion of extras, such as mattresses or railings
- rental versus purchase
Medicare coverage
After a person’s doctor certifies that a bed is medically necessary and the person obtains it from a Medicare-approved supplier, they will pay 20% of the Medicare-approved amount.
If a person has not met their Medicare Part B deductible, it will apply to the purchase or rental. For 2024, the Medicare Part B deductible is $240.
As Medicare does not fully cover the costs of an adjustable bed, a person may need financial assistance to pay for the deductible or copay relating to an adjustable bed.
Some of the potential sources of help with costs include:
- Medicaid: Medicaid is a state and federal program that can help someone with low income get financial assistance with healthcare costs. While Medicaid policies may vary by state, this program may help pay for an adjustable bed.
- Department of Veterans Affairs: Supplemental Medicare policies, such as TRICARE for Life, may help a veteran pay the Medicare copay. Other programs that may help veterans get financial assistance for adjustable beds include the Veteran-Directed Home and Community Based Services program and the Aid and Attendance program, which helps homebound veterans.
- Philanthropic organizations: Nonprofit organizations may help with the costs of DME. The assistance must generally be specific to conditions, such as through the Muscular Dystrophy Family Foundation, which may be able to assist with accessing financial resources.
A person may wish to ask their doctor about potential sources of financial support in their community.
Below are answers to common questions about getting cover for adjustable beds.
Can a doctor write a prescription for an adjustable bed?
A doctor can write a prescription for an adjustable bed. In order for Medicare to cover some of the costs of an adjustable bed, a doctor must write a prescription stating that the bed is medically necessary.
Does Medicare cover Tempur-Pedic beds?
Medicare might cover part of the cost of an adjustable Tempur-Pedic bed. However, there are numerous eligibility requirements. A person can contact Medicare to find out more.
Can you get a Sleep Number bed with Medicare?
Medicare may cover part of the cost of a Sleep Number bed, depending on factors such as eligibility and the availability of other adjustable beds. A person can contact Medicare to discuss their coverage.
Medicare will cover a portion of the rental or purchase of adjustable beds, provided a doctor prescribes the bed as medically necessary.
A person must ensure that their doctor and the bed supplier accept Medicare assignment to receive the maximum coverage.
If they need help covering the copays for the adjustable bed, the person may be able to apply for Medicaid benefits or community assistance.