Durable Medical Mattresses and Beds Covered Under Medicare

It might seem surprising, but Medicare can actually assist you in obtaining a new mattress. While this may sound unconventional, Medicare has provisions that could potentially cover the expenses of your next mattress, offering you a chance to save.

Medicare is renowned for its support in helping elderly Americans meet their medical needs and healthcare costs. It encompasses coverage for doctor’s fees, hospital stays, laboratory tests, and other related medical expenditures. Additionally, Medicare can extend its support to cover essential equipment required for a patient’s treatment.

Under Medicare, there are two primary coverage components: Part A and Part B, designed to aid with significant medical expenses. Part A caters to hospital expenses, while Part B encompasses doctor’s fees and laboratory work. Moreover, Part B offers coverage for essential home equipment through its qualification for Durable Medical Equipment (DME).

Understanding Durable Medical Equipment (DME)

To qualify for Medicare coverage, an item must meet the specific criteria of being categorized as Durable Medical Equipment (DME):

  • It should be deemed medically necessary and prescribed by a certified medical professional.
  • The item must be designed for extended durability, with a projected lifespan of three years or more.
  • Prescription requests need to be submitted within six months of the patient’s physical examination by a medical practitioner.
  • Adequate documentation proving medical necessity must accompany the request.
  • Medicare coverage for Durable Medical Equipment is contingent upon obtaining the item from a Medicare-approved provider.

Medical Beds

For an item to be recognized as Durable Medical Equipment, a bed should typically fall under the category of a “hospital bed,” primarily designed for medical necessity rather than comfort. These beds offer various adjustable features, including altering the head and foot angles and heights. Some models even include adjustable mattress heights from the floor.

Medicare coverage might extend to hand-crank or hand-held electric motor-controlled hospital beds, depending on the patient’s requirements. While fully electric motor beds are usually not covered, exceptions may exist for larger or wider beds, especially for patients with obesity.

Medical Mattresses

Medical mattresses seeking Medicare coverage must fulfill the Durable Medical Equipment (DME) classification criteria. They should be engineered for medical purposes, prioritizing medical care over comfort. Specifically, Medicare covers pressure-reducing mattresses designed to alleviate pain and contribute to healing.

Some top-rated pressure-reducing mattresses include:

  • Joerns PrevaMatt Defend Pressure Relief Mattress
  • Solace Resolution Glissando Heavy Duty Mattress
  • Therapeutic 5-Zone Support Mattress
  • ThevoRelief Pressure Relief Mattress

Special Considerations

Contrary to expectations, Medicare could indeed contribute towards the cost of your next mattress. Medicare assists by covering 80% of the expenses for approved DME items, leaving you responsible for the remaining 20%.

For more comprehensive coverage, you might explore Medicare Advantage, a supplementary insurance policy offered by private insurers. These policies could offer more extensive coverage for DME items compared to Part B.

It’s noteworthy that patients in care facilities or at a relative’s home can still satisfy the requirement for using DME intended for home use.

To access coverage for DME items, including medical mattresses, procurement should be done through an authorized DME supplier.

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