Mattresses Covered By Medicare

by Nancy

Making sure you have the proper mattress that offers you both the necessary back support and comfort is not an easy task.  There are so many mattresses on the market that making a choice requires extensive research and testing. Making the mattress selection process even more difficult is price, as mattresses are usually expensive products and require a significant investment on your part. For those on medicare finding a proper mattress is made all the more difficult.

Luckily, Medicare Part B has provisions that may help cover the cost of your mattress. Medicare Part B offers Durable Medical Equipment coverage (DME coverage). Medicare Part B covers the cost or the majority of the cost of medically necessary durable medical equipment, provided that your doctor has prescribed the DME for use in your home. DME coverage is not only for mattresses. Blood Sugar monitors and test strips, canes, crutches, infusion pumps, oxygen equipment, and wheel chairs are just some of the additional DME that may be covered under Medicare Part B.

So how does DME coverage work?  Does your medicare plan pay the entire cost of the DME? Are there any restrictions?  The answers to these three questions will help you get a better idea of how Medicare Part B DME coverage works, and what you need to do to get a new mattress through Medicare Part B. The first thing you need to know is that DME coverage generally has three different payment plans.  For any DME that is accepted, you will need to pay 20% of the total medicare approved cost of the DME.  Your Medicare Part B deductible will apply to this expense. Medicare Part B will then pay the remainder of the cost.  However, Medicare Part B may enforce some restrictions based on the equipment and the duration it is needed.  Some DME coverage requires that you rent the equipment. In other cases you may be required to buy the equipment. In some cases you have the leeway to decide whether or not to rent or buy.

Medicare Part B only covers your DME if both the doctor who prescribed the DME for your use, and the supplier of the DME are enrolled in Medicare.  Both doctors and suppliers must meet stringent requirements to be enrolled in medicare.  If either of your doctor or supplier are not enrolled in Medicare, Medicare Part B will not cover any of the cost, and there will not be a medicare set cost limit to the DME. Suppliers may also be enrolled in medicare but not actively participate in Medicare.  If they are considered participating suppliers they must accept the cost that medicare sets for the DME and supply it to you. However, suppliers who are enrolled but not participating have the option to refuse to supply you with the DME at the medicare set cost, and can charge you up to the full price of the DME.

To get an adjustable mattress of Hospital bed through Medicare you need to find a participating supplier.  if you are unsure if you have an available supplier for your DME needs, you can search the Medicare.gov website to find a supplier near you. Remember that while some suppliers may be enrolled in Medicare, if they are not actively participating, they will not be subject to the Medicare Price limitations. A common and well regarded brand of adjustable bed/ mattress for those over the age of 55 is Innomax.  Innomax makes many adjustable beds that may be supplied by Medicare enrolled suppliers. If you want more specific information on Innomax beds you can check their website, at Innomax.com.