Hospital Beds Covered By Medicare – Original Medicare (Parts A and B) will cover an adjustable bed, such as a hospital bed, but some conditions must be met first.
Adjustable beds are covered by Medicare Part B. However, Part B may not always cover the purchase of a bed – only a rental or loan while you need it.
Hospital Beds Covered By Medicare
Medicare Part B pays for outpatient medical expenses, such as permanent medical equipment. This includes adjustable beds. Part B will cover these beds when your doctor orders one for you to use in your home.
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In order for Part B to cover your adjustable bed, both your doctor and the company that will provide the bed must be enrolled as Medicare providers.
“Adjustable bed” is a general term for a bed that does not stay flat or stationary. Adjustable beds allow you to move or raise different parts of the bed according to certain needs.
One example is a hospital bed that may allow you to raise the head or foot of the bed.
Medicare covers an adjustable bed when you have a special medical need for it. You must go face-to-face with the doctor or provider within 6 months of the doctor ordering the bed.
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You must also be enrolled in Medicare Part B, which is part of original Medicare, to have an adjustable bed or other durable medical equipment.
Medicare generally covers basic hospital beds, but your options include some items, exceptions, and add-ons if your doctor thinks they’re necessary.
For example, adjustable heights, power beds and side rails are not part of the basic coverage, but can be added if your doctor orders them for you. There may still be coverage limitations, but Medicare will pay at least a portion if these supplements are necessary for your condition.
Medicare also covers some bed or bedding accessories. The following is a list of what is included in the durable medical equipment list of specific covered items:
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In general, hospital bed prices range from $500 to over $30,000. Some of the more expensive types, such as intensive care beds, are only available for rent. You can also find suppliers who refurbish used beds and sell them or offer them for rent.
If the provider you choose approves your Medicare plan, Medicare will pay 80 percent of the approved amount and you will pay the remaining 20 percent. You must also pay your Part B deductible.
Without Medicare, you would have to use private insurance or pay the full amount for bed purchases or rent.
If you need an adjustable bed and you have Medicare, you probably have most of the coverage you need. Medicare Part B is part of original Medicare.
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Original Medicare includes Part A and Part B. You are automatically enrolled in Part A at age 65, but you must enroll in Part B yourself. If you decide not to enroll when you first become eligible, you may have to pay a late enrollment fee.
Adjustable beds such as hospital beds are included in payments for permanent medical equipment covered under Part B, which covers outpatient care.
If you have a Medicare Advantage plan, also known as Medicare Part C, you will have all the basic coverage that original Medicare offers. Plus, you should have some extra coverage. This coverage may include allowances for certain services or equipment.
When Medicare covers your adjustable bed, it will pay 80 percent of the approved amount. You pay the remaining 20 percent of the insured cost.
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You must also pay your Medicare Part B deductible and any costs that are not eligible under your Medicare coverage, such as extra procedures not included in the doctor’s order.
To help control your cost-sharing, a Medicare supplement plan, also known as Medigap, can help. These plans provide help with your out-of-pocket costs after Medicare has paid its share.
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What Diagnosis Qualifies For A Hospital Bed?
Medicare Part A covers hospitalizations, but you are responsible for the Part A deductible. After 60 days, a co-insurance must be paid and the amount increases depending on the length of stay.
Since the average cost of a three-day hospital stay is around $30,000, it’s important to make sure you’re covered for hospital visits.
HealthCare.gov. Protection against high medical costs. Accessed September 6, 2023. See all sources. As long as your hospital accepts Medicare and you have an official doctor’s order stating that hospital care is necessary for your treatment, Medicare Part A will cover your hospital stay. Medicare Part A will sometimes cover hospitalization if you do not meet these criteria as long as the hospital’s utilization committee approves your stay during the hospitalization.
Be aware that Medicare Part A only covers Medicare-approved hospital services and products, not the medical services you receive while in the hospital, which are covered under the umbrella of Medicare Part B. Your Part B coverage pays 80% of some Medicare services -recognized doctors you receive at the hospital.
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Medicare Part A has a deductible of $1,600 in 2023 ($1,632 in 2024) for each benefit period. After your deductible is met, here’s how insurance and coinsurance work:
The benefit period begins on the day you are admitted to an inpatient or nursing facility. It ends when you have not received inpatient hospital or nursing care for 60 consecutive days. If you are approved after that, you have started a new benefit period and must pay the deduction again.
Medicare supplement insurance, or Medigap, can help reduce hospital costs that Medicare Part A (hospital insurance) and Part B (medical insurance) do not cover. Depending on the type of Medigap plan, you can purchase a policy that covers Part A deductibles, Part A coinsurance, and hospital expenses and the first three liters of blood for transfusion.
Medigap plans are standardized, so you get the same Medicare benefits from any company that offers a particular plan. However, the premiums and available plans may vary depending on your location, so it’s important to shop around to find the most affordable plan that best suits your health needs.
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Medicare Advantage plans are required to provide the same coverage as Original Medicare. So whichever Medicare Advantage plan you choose will cover the same services—and some plans may offer additional benefits like full hospital coverage beyond 90 days. However, some Medicare Advantage plans have a daily copay that starts as early as your first few days or a full week in the hospital—and that daily cost could be significantly more than your Part A deductible, depending on your specific plan and the length of your stay (There is no (for the first 60 days of basic hospitalization with Medicare Part A, except for the Part A deductible.)
Because Medicare Advantage is offered through private health insurance companies, terms, payments, coinsurance, and benefit information vary by plan—and benefits are greatly reduced if your hospital or doctor is out-of-network, unless you need it urgently or for an emergency. care.
When comparing Original Medicare and Medicare Advantage hospital coverage, consider the total potential out-of-pocket costs for an extended hospital stay. Original Medicare doesn’t cap your total hospitalization costs (unless you have a Medigap plan that covers some out-of-pocket costs), but Medicare Advantage plans cap annual costs after you reach a spending threshold. That can be up to $8,300 out-of-pocket in 2023 ($8,850 in 2024). Then they will pay 100% of covered services for the rest of that year (as long as you used network providers and hospitals).
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Roberta Pescow is a freelance writer specializing in health, home improvement, food, personal finance and lifestyle. Her articles have been published on more than 200 websites nationwide. Read more
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