Does Medicare Pay For Lift Chairs?

Does Medicare Pay For Lift Chairs?
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Does Medicare Pay For Lift Chairs?

Does Medicare Pay For Lift Chairs?
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As people get older, they find it more difficult to do everyday activities, such as getting up from a chair. To most people, a lift chair might seem like a luxury, but for many, it’s a necessity. 

For seniors who value their independence and want to do as much as possible on their own, a lift chair can be a good investment. 

This article will teach you everything you need to know about lift chairs, including the types available, their uses, the cost, and how Medicare can help you cover them.

What Is Medicare?

Medicare is a U.S.  federal health insurance program for people 65 and older, some younger people with disabilities, as well as people with end-stage renal disease (ESRD) or amyotrophic lateral sclerosis (A.L.S.).

Medicare comprises  Part A, Part B, Part C, and Part D.

Key Point:  You Can Get Medicare Coverage in Different Ways

Original Medicare This is the government-run version of Medicare cover that anyone over the age of 65 can get. Original Medicare covers Part A (inpatient) and Part B (outpatient) services, tests, and items. It does not cover Part D (prescription drugs).

Medicare Advantage Plans Medicare Advantage Plans, previously known as Part C Plans,  are health plans offered by insurance companies that have contracts with Medicare. These policies cover Part A, B, and D expenses, including costs for hospital care, prescription drug coverage, and doctor’s visits.

Prescription Drug Plans (PDPs) Stand-Alone Part D Plans (Prescription Drug Plans) cover self-administered prescription drugs. For example, medications for high blood pressure, pain tablets, and antidepressants.

Medicare Supplement Insurance Medicare Supplement Insurance is a health plan for people who have Original Medicare and cover out-of-pocket costs such as deductibles, coinsurance, and copayments.

What Are Lift Chairs?

A lift chair, which looks like a reclining chair, is an adjustable chair that helps someone move from a sitting to a standing position. To get the chair to raise or tilt, you push a button. 

Sometimes lift chairs have heating and massage features that make them even better. If you want to sleep in the chair, you may even be able to lie on the chair completely flat.

Chairs with extra features or those made from premium materials are more expensive. Chairs can cost several hundred dollars, with costlier options being over a thousand dollars. 

Key Point:  What Are Upholstery Materials?

Upholstery refers to  the materials, including fabric, padding, webbing, and springs, that make up the soft coverings of chairs, sofas, and other furniture. 

Modern upholstered items use metal springs and foam for greater durability.

Key Point: Stairlift vs. Patient Lift

Important: A lift chair isn't the same as a stairlift or a patient lift.

A stairlift is a seat connected to the wall of a staircase that takes you from the bottom to the top of the staircase by the touch of a button. 

A patient lift is a sling or sit-to-stand lift that uses electrical or hydraulic power to move people between a bed and chair or similar resting places. 

There are four main types of lift chairs namely:

  • Two-position chairs

  • Three-position chairs

  • Infinite-position chairs

  • Zero-gravity lift chairs

Two-Position Lift Chair

There are different types of lift chairs. A two-position lift chair is the simplest one and offers two different reclining positions: 

  1. The standard 90-degree upright angle.

  2. A 45-degree recline.

Two-position lift chairs have a single motor that facilitates reclining and leg elevation. 

Three-Position Lift Chair

The three-position lift chair also has both an upright angle and a 45-degree recline. 

Just like a two-position chair, this chair has one moving part that shifts all of its other components.

It also features a reclining angle that goes almost entirely flat so that your back and joints don't have to work as hard. This also creates a good position for napping, reading, or watching TV. 

Infinite-Position Lift Chair

The infinite-position lift chair is the most flexible type of lift chair. It allows you to set your chair in several ways to find the position that's the best for you.

If you like, you can sit upright or lie flat. You can also have your back at a 45-degree angle and your legs raised.

Zero-Gravity Lift Chair

A zero-gravity lift chair is a type of infinite-position lift chair that allows your legs to rise above the angle your head is at when you are lying flat. 

The chair operates on two separate motors, one controlling the back recliner and the other the leg recliner.

These chairs offer the most freedom and they are also the most expensive type of lift chair.

Lifted seat Seated Chair Reading Chair Napping Chair Relaxing Chair Sleeping Chair Trendelenburg Chair Zero-gravity Chair
Lifted Seated Reading Napping Relaxing Sleeping Trendelen-burg Zero- gravity
Two-position ✔️ ✔️ ✔️
Three-position ✔️ ✔️ ✔️ ✔️
Infinite-position ✔️ ✔️ ✔️ ✔️ ✔️ ✔️
Zero-gravity ✔️ ✔️ ✔️ ✔️ ✔️ ✔️ ✔️ ✔️

Who Uses Lift Chairs?

You might be wondering if you need a lift chair. If you answer yes to any of the following questions, a lift chair might be worth considering:

  • Do you have a hard time standing or sitting?

  • Have you been spending more time in your recliner?

  • Do you plan on aging in one place?

  • Are you at a higher risk of falling?

  • Do you have painful joints, sore knees, or aching back?

  • Have you had issues with swelling in the legs or feet?

Does Medicare Cover Lift Chairs?

Yes, some of the costs of your lift chair will be covered under Medicare Part B’s durable medical equipment (DME) coverage.

Key Point: What Is Durable Medical Equipment (DME) Coverage?

DME are equipment and supplies ordered by a healthcare provider for everyday or extended use. 

The coverage for DME may include: 

However, DME Coverage only pays for your lift chair if your doctor or other healthcare provider says it should be used in home health care.

Key Point: What Is Home Health Care?

Home health care is medical care that is given to a patient at home to treat diseases or injuries. There is a range of treatments that people can receive in the comfort of their own home, including:

  • Nursing care
  • Physical therapy
  • Occupational therapy
  • Speech therapy

If you get Medicare-covered care at a nursing home or hospital, it isn’t technically your home. This means Medicare will not cover your lift chair under their home health care benefit.

However, a skilled nursing facility (SNF) might be able to cover some of your lift chair costs.

Key Point: What Is a Skilled Nursing Facility (SNF)?

An SNF is an inpatient rehabilitation and medical treatment center staffed with trained medical professionals. 

They provide the medically necessary services of:

  • Licensed nurses
  • Physical and occupational therapists
  • Speech pathologists
  • Audiologists

Instead of paying for the whole chair, Medicare Part B only pays for the device that lifts you up. As a result, there won't be any coverage for cushions, fabric, or other parts of the chair.

Do I Qualify for a Medicare-Covered Lift Chair?

In 1986, Medicare started to pay for lift chairs based on medical necessity, not diagnostic categories. For your lift chair to be a medical necessity, here are the requirements:

  • A doctor has to determine that you need it for medical reasons.

  • The lift chair is part of a doctor’s treatment and is likely to help improve your health or slow its decline.

  • Your condition is so severe that the only option is to stay in bed or sit in a chair.

Both your doctor and the company that makes the lift chair must be Medicare-approved or  Medicare will not pay your claim. 

Suppliers who work with Medicare can only charge you coinsurance and the Part B deductible for the amount approved for the DME.

Key Point: Terms You Should Know

Deductibles are amounts that people have to cover before their Medicare plan or insurance starts to pay for medical expenses.

Coinsurance is the percentage of costs of a covered health care service you pay (for example 20%) after you've paid your deductible.

The Cost of Lift Chairs

Two-position lift chairs tend to be the most economical option with prices starting at about $600. However, many factors influence the cost of a lift chair, such as:

  • Quality.

  • Reclining capabilities.

  • Optional features and functionalities.

It’s essential to keep in mind how often your lift recliner will be used and what purpose it will serve. 

There are three lift chair price brackets and you can expect the quality of design, construction, and comfort to improve with each price range. The cost brackets are as follows:

The Most Affordable Lift Chair ($499 - $1,200)

Lift chairs in this price bracket offer an affordable way to get a chair with full lift functionality at a reasonable price. 

This bracket includes two-position and three-position lift chairs with limited features.

The Mid-Range Lift Chair ($1,200 - $2,499)

In the middle price range, there are three-position lift chairs with more features, as well as infinite-position lift chairs.

The price will vary according to:

  • Product quality.

  • A number of features.

  • A number of customizations.

The Luxury, High-End Power Lift Chair ($2,500 and higher)

This price range is mostly made up of high-quality, infinite-position lift chairs with two or more motors for extra lifting power.

High-end lift chairs are usually made for people with bigger figures. They have seats that are deep, wide, and tall, and can hold up to 700 pounds.

How to Get Reimbursed for Your Lift Chair

If you buy a lift chair from a Medicare supplier, you'll likely have to pay for the chair in full upfront and then ask Medicare for partial reimbursement.

The supplier will usually file a claim on your behalf, as long as it is registered with Medicare as a Durable Medical Equipment Supplier.

If you want to verify whether a company is registered, visit the Medicare website and type in your zip code.

It's possible that the supplier won't file the claim, so you can do it yourself. To make a claim, you'll need the following:

  • The claim form.

  • An itemized bill.

  • A letter that explains why the claim is being made.

  • Documents that back up the claim, such as a doctor's prescription.

The claim must be filed within 12 months of when you bought the lift chair.

If you want Medicare Part B to pay for the mechanism that lifts the chair, you'll first need to meet your deductible, which is $233 in 2022.

After that, you'll pay 20% of the Medicare-approved amount. You'll also have to pay the full price of the rest of the chair.

Key Point: How Does a Medicare Part B Deductible Work?

A Medicare Part B deductible is an amount you pay for Medicare Part B-covered healthcare services before it starts to pay.

After you meet your deductible for the year, you typically pay 20% of the Medicare-approved amount for these:

  • Outpatient Therapy
  • Durable Medical Equipment (DME)

Learn More about Medicare and Its Coverage Options

If you want to find out more about Medicare and what it covers, head to PolicyScout’s Medicare hub to compare your options and find the best plan in your area.

We have accurate, up-to-date information about everything Medicare-related, including plans, such as Original Medicare and Medicare Advantage.

If you are looking for personalized guidance, send your questions to Help@PolicyScout.com or call us at 1-888-912-2132 to get assistance from one of our experienced Medicare consultants.

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