Health insurance can be a literal life saver. But, it can also be a ball of confusion; you must know the nitty-gritty of your coverage. Fine print, hidden charges, plus a gamut of clauses make it difficult to know what you’re entitled to and what you need to pay—especially if you’re on Medicare.
For instance, did you realize that the Medicare program could cover the cost of your next bed, or even that of your next mattress? This is one benefit that you may not have been aware of, as understanding Medicare coverage can often be quite perplexing. But, if you are afflicted with back pain, spinal problems, or some other form of ailment that requires a medical or adjustable bed or a specific type of therapeutic mattress, then those purchases could qualify as medical equipment and may fall under Medicare coverage.
Here’s what you need to know.
Medicare and Durable Medical Equipment
Durable Medical Equipment, or DME, is defined as any type of medical equipment that you use in your home to improve your quality of living. These types of equipment help you live a better life and assist you in your daily activities. Some examples are walkers, wheelchairs, oxygen tanks, blood testers and other monitors, even a brand new hospital bed, among others. As stated in the name, DMEs are meant to be durable to withstand repeated use. DMEs are covered by most insurance plans, and, in some cases, by Medicare. Items that are medical equipment, but do not necessarily allow repeated or prolonged use, such as catheters, compression stockings, incontinence pads, and the like, are not covered by Medicare.
Medicare classifies certain beds and mattresses as Durable Medical Equipment
When it comes to beds and mattresses, Medicare considers specific types as DMEs. Some things you need to know, first:
- Your doctor must prescribe the bed or mattress
- Medicare covers adjustable beds, but with conditions
- The bed or mattress your doctor orders must be from a company that participates in the Medicare program.
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Some ailments for which your doctor might order an adjustable bed or therapeutic mattress include:
- Back and cervical-spinal problems
- Spinal cord injuries
- Arthritis
- COPD and other respiratory or breathing problems
- Certain cardiac diseases
- Ailments that cause muscular pain and require you to shift positions constantly
Your bed or mattress could qualify as a DME under Medicare if it is, among other types:
- An adjustable hospital bed, whether fixed height or variable height
- A bed that reduces pressure
- A mattress that reduces pressure
- A bed overlay that reduces pressure
- A hospital-grade pediatric crib, for infants with ailments
You also need to know that most of these types of beds or mattresses are covered under Medicare Part B, so you must be enrolled in that program. Additionally, Medicare typically covers 80% of the purchase amount, while you shoulder the remainder of 20%, along with your Part B deductible.
You need to find a Medicare-accredited bed or mattress supplier
As mentioned earlier, and to avoid any problems with your claim, you will need to make your purchase from a Medicare-accredited supplier of beds and mattresses considered as DME. As such, you will need to search online (or, perhaps your doctor has a list) for a bed or mattress supplier in your area that is part of the Medicare program.
The right type of bed or mattress will not only help relieve your pain and improve your specific ailment; it will improve your life, on the overall. Better sleep, after all, is integral to your general sense of wellbeing.
