Medicare will cover some of the cost of a lift chair if a doctor says it is medically necessary. A person usually needs to buy the lift chair and then submit a claim to Medicare.
Lift chairs look like reclining armchairs. They use an electronic system to gently move a person from a seated position to a standing position or from a standing position to a seated position.
Medicare classes the lifting mechanism in a lift chair as durable medical equipment (DME) — medically necessary equipment that should last several years. Medicare Part B and some Advantage plans may cover the cost of the mechanism.
This article discusses when Medicare considers a lift chair medically necessary, coverage, and possible out-of-pocket costs.
Glossary of Medicare terms
We may use a few terms in this piece that can be helpful to understand when selecting the best insurance plan:
- Deductible: This is an annual amount that a person must spend out of pocket within a certain time period before an insurer starts to fund their treatments.
- Coinsurance: This is a percentage of a treatment cost that a person will need to self-fund. For Medicare Part B, this comes to 20%.
- Copayment: This is a fixed dollar amount that an insured person pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.
Medicare covers costs related to the medically necessary part of the lift chair. This means that the plan covers the mechanism that moves the chair but not the chair itself. A person is solely responsible for paying for the other parts of the chair, such as fabric, cushion, and accessories.
Usually, an individual will need to pay for their lift chair upfront and then submit a claim to Medicare for reimbursement.
What will I pay?
Medicare Part B will cover 80% of the cost of the motorized lifting device. An individual must pay the remaining 20% coinsurance out-of-pocket. They must also pay their Part B annual deductible, which is $240 in 2024, and the cost of the chair itself.
Medicare Advantage plans must have at least the same coverage as Original Medicare. Therefore, the same rules apply, but out-of-pocket costs may vary between plan providers.
For Medicare to contribute toward a lift chair, a person must have Medicare Part B, which is medical insurance, or a Medicare Advantage plan. People with an Advantage plan need to talk with their insurer about costs, suppliers, and coverage rules.
It is also essential to purchase a chair from a Medicare-participating supplier that accepts assignment otherwise Medicare will not pay toward the cost.
A person requires a doctor’s prescription for a lift chair. Additional out-of-pocket costs may include a coinsurance or copayment for doctor’s visits.
When the doctor gives a prescription for the lift chair, they must also complete the Certificate of Medical Necessity CMS-849, which is the Seat Lift Mechanisms form.
When do doctors recommend lift chairs?
A lift chair may be medically necessary for people who cannot stand unassisted from a seated position.
A person must meet the following requirements for a doctor to prescribe a lift chair:
- They have severe arthritis of the hip or knee or another severe neuromuscular disease.
- They cannot stand up from a regular chair.
- The patient can walk independently or with a walker or cane. If a person transfers directly from a chair to a wheelchair, Medicare may not contribute to the cost of a lift chair.
- The doctor recommends a lift chair to improve a person’s condition or slow deterioration.
Medicare supplement insurance, also called Medigap, may help pay for some out-of-pocket costs relating to the purchase of a lift chair.
Medigap works alongside Original Medicare and can help with expenses such as coinsurance and copayments. However, current Medigap plans are unable to assist with the Part B deductible.
If a person has questions about their Medigap plan coverage, they can contact the private insurance company that administers the policy.
Lift chairs can cost hundreds to thousands of dollars. The cost of a lift chair depends on several factors, including:
- whether the chair is reclining
- the chair manufacturer
- whether the chair has any special features, such as massage
The amount Medicare will reimburse for a seat lift mechanism depends on the state a person lives in and the company that supplies the chair.
Medicare has a supplier directory where a person can search for a DME supplier in their zip code. Individuals can type in their zip code and search for “seat lift mechanism”.
Typically, people pay for a lift chair upfront and then receive reimbursement from Medicare. Medicare-participating DME suppliers usually file a claim on the recipient’s behalf.
Medicare will only reimburse people who buy a chair through a supplier who accepts Medicare assignment. If the company does not accept Medicare assignment, individuals may pay more for their lift chair.
Other stores that sell lift chairs, such as department stores, do not accept Medicare. A person can choose to buy their chair through these stores but will pay 100% of the cost.
Medicare resources
For more resources to help guide you through the complex world of medical insurance, visit our Medicare hub.
A lift chair helps people move from a seated position to standing.
Medicare Part B and Advantage plans cover the electronic lifting mechanism inside a lift chair but not the other parts of the chair. Part B covers 80% of the lifting mechanism and the recipient of the chair pays the remaining 20%, their annual deductible, and the cost of the chair.
A person must buy a lift chair from a provider who accepts Medicare assignment, and a doctor’s prescription is necessary.