Medicare and Mattresses

Health Insurance, especially Medicare, can be very confusing. Not knowing what may or may not be covered under your plan is a common reality for many. If you’ve heard from others that you could get a new mattress under Medicare coverage, you heard correctly, but you must meet certain requirements. Unfortunately, it’s not as simple as walking into a mattress store and saying you have Medicare coverage, then walking out with a free mattress. However, it is possible to get a new mattress given the right coverage. Let us help you find out if you qualify for a new mattress that would be covered under your insurance.

Medicare Part B – Durable Medical Equipment Coverage

Medicare Part B offers Durable Medical Equipment coverage (DME coverage), which is equipment that is used to help patients function in their everyday lives. 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. In order for your mattress to be covered, it must qualify as DME. Unfortunately, not everyone will qualify for DME, so you must be the requirements and get a prescription from your doctor. In addition to a prescription, here are the other mandatory criteria that need to be met for Medicare coverage:

  • It must be used for medical purposes
  • It needs to be durable and meant for repeated use
  • It is not useful to someone who isn’t sick or injured
  • You can use it at home
  • The item’s general life expectancy should be at least three years

 

What Kind Of Mattresses Are Covered?

There are certain types of mattresses that Medicare will cover, which means not all qualify as durable medical equipment. In order to qualify, they must serve a medical purpose and help you function on a daily basis. It’s important to understand which ones may be covered before going out and buying any mattress you want, thinking it will be covered.

There are three main types of beds and related equipment that Medicare will cover:

  1. Pressure-reducing beds
  2. Pressure-reducing mattresses
  3. Pressure-reducing overlays

After you meet all of the qualifications, it’s best to purchase your mattress through a Medicare supplier, to save money. You can find these suppliers simply by looking online for Medicare-approved sellers near you. 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.

The Best Adjustable Beds & Mattresses

Once you’ve been approved for a mattress, now the fun part begins…shopping! One of the most desired mattresses for DME is an adjustable bed. Adjustable beds are usually associated with a motorized base that can move into different positions by raising the head and foot of the bed. There are some that also include other features like built-in massagers and lighting. Adjustable mattresses change in firmness through methods like air chambers or interchangeable springs and are perfect if you’re just looking to switch up your comfort levels instead of the bed’s position. Here are some of the top adjustable beds in the market today…

If you need assistance with finding out if you qualify for a mattress covered by Medicare, you should review your plan and contact your doctor. For more assistance and information, you can simply visit Medicare.gov.