Whether it is basic mobility malfunctions, or something more complex such as the development of osteoarthritis and rheumatoid arthritis, lift chairs may be an appropriate investment. Medicare beneficiaries have coverage from Medicare Part B, when lift chairs are deemed to be medically necessary due to the patient’s condition. So, what exactly are the Medicare rules and exceptions? Or how much will lift chairs cost through Medicare? Here’s what to expect.
When Does Medicare Cover Lift Chairs?
Medicare may cover a lift chair based on the following:
- If it is deemed to be medically necessary.
- If you are not currently living in a nursing home requiring skilled care or an inpatient in a hospital.
- Medicare may not cover a lift chair if it has previously covered the cost of a mobility device like a scooter or a motorized wheelchair.
Medicare may not cover a lift chair based on the following:
- For any chair that utilizes any type of spring device to lift a patient out of the chair.
- Will also not cover any additional costs for fabric or specialized cushions that come with a lift chair.
Medicare will pay for 80% of the cost of the motorized device that powers the Lift Chair while you will be responsible for the remaining 20% of the motorized components cost.
Once you have selected the lift chair that best suits your needs you can then move forward with purchasing the lift chair on your own and submit a reimbursement claim directly to Medicare. Some providers of lift chairs may file a reimbursement claim for you with Medicare. The amount of reimbursement for a lift chair from Medicare may range from $280 to $300. In addition, Medicare has very strict standards for the lift chairs that will be covered. Qualified individuals may exhibit the following:
- Eligible Medicare beneficiaries are unable to stand up from a sitting position when sitting in a standard armchair.
- Eligible Medicare beneficiaries have been diagnosed by their medical provider either with severe arthritis that is in either your hips or knees or with a Severe Neuromuscular Disease that significantly impairs their mobility.
- Eligible Medicare beneficiaries who do not have access to the lift chair would otherwise be confined either to a chair or bed.
- Eligible Medicare beneficiaries must be able to operate the lift chair on their own.
- Eligible Medicare beneficiaries must be able to walk with a cane or walker or other mobility device once they are standing up.
What Does “Medically Necessary” Mean?
For your lift chair to qualify as medically necessary durable equipment under Medicare’s Rules, your doctor or health care provider must determine that it is essential to treat your medical ailment in compliance with all accepted medical practice standards. In this case, your physician or health care provider will be required to write you a prescription for your lift chair with the stipulation that it is absolutely “medically necessary” to treat your medical condition. For more information visit Durable Medical Equipment: What Qualifies for Medicare Coverage?
Your doctor or health care provider will be required to fill out and complete the form Certificate of Medical Necessity for Seat Lift Mechanism (CMS 849) which will enable you to file for a Medicare reimbursement for the Medicare approved cost of the mechanism.
The required form which delineates the lift chair supplier’s name, your physician’s name, your medical information including your medical diagnoses of either severe hip or knee arthritis, and the narrative description of the equipment and exact cost.
How to Select the Perfect Lift Chair?
Make sure you shop from a Medicare approved supplier to ensure reimbursement and be sure to test out different styles of lift chairs for fabric and comfort.
Medicare will cover any of the three basic types of lift chair their differences are as follows:
- Two lift chairs have two different reclining positions which include a ninety- degree upright angle and a forty-five-degree angle which elevates your feet and allows your back to be at a forty-five-degree angle.
- Three position lift chairs include the ninety degree and forty-five-degree angles along with a fully reclining angle that allows you to lay fully back which relieves pressure from the hips and back.
- Infinite position lift chairs allow for multiple comfort settings at many different angles, including lifting your feet above your head when fully reclining. Infinite Position Lift Chairs are powered by two separate motors which allow for the flexibility of reclining settings.