Hospital beds are not just for hospital patients. They are available for home use as well. However, a hospital bed is a big medical expense. Thankfully, a hospital bed can be prescribed if your condition requires it, and Medicare will cover it.
In this MedicareWireMedicareWire is a Medicare insurance consulting agency. We founded MedicareWire after seeing and hearing how confusing and frustrating it is to find, understand, and choose a plan. Our services are free to the consumer. article, we’ll go over some situations to help explain when and how Medicare will cover a hospital bed. We’ll also explain the out-of-pocket costsOut-of-Pocket Costs for Medicare are the remaining costs that are not covered by the beneficiary's health insurance plan. These costs can come from the beneficiary's monthly premiums, deductibles, coinsurance, and copayments. once Medicare pays its share.
- Hospital beds are used to help treat a condition that requires your body to be reclined in a certain position.
- Medicare Part BMedicare Part B is medical coverage for people with Original Medicare benefits. It covers doctor visits, preventative care, tests, durable medical equipment, and supplies. Medicare Part B pays 80 percent of most medically necessary healthcare services. will cover 80 percent of a hospital bed purchase or rental from a Medicare-approved supplier.
- If you rent a hospital bed from a Medicare-approved supplier for more than 13 months, you may keep the bed.
- You can expect to pay $100 to over $11,000 for a hospital bed after Medicare coverage, depending on the features and size of the bed.
- Additional accessories and features for the hospital bed can add to this estimated average.
- A Medicare Advantage Plan will cover the cost of a hospital bed, just like Medicare Part B, but their out-of-pocket costs and replacement policies can vary between plans.
- Medigap can help cover the remaining costs of a hospital bed, as long as Medicare Part B approves and covers it first.
What Conditions Qualify For A Hospital Bed?
An at-home hospital bed is considered medically necessaryServices or supplies that are needed for the diagnosis or treatment of your medical condition and meet accepted standards of medical practice. when your condition requires you to maintain a particular position to maintain or treat it. If your medical condition requires certain medical devices that cannot be attached to a normal bed, that may also qualify you for a hospital bed for your treatment. Here are some conditions that could make a hospital bed medically necessary for your treatment:1CMS.gov, “Medicare Coverage Issues Manual”, Accessed December 21, 2021
- Severe cardiac diseases
- Chronic obstructive pulmonary disease
- Spinal cord injuries, including quadriplegic and paraplegic patients, multiple limb amputee, and stroke patients
- Severe arthritis
- Fractured hip
- Late-stage pressure ulcers
How Will Medicare Cover My Hospital Bed?
Hospital beds fall under the classification of durable medical equipmentDurable medical equipment (DME) is equipment that is designed to last and can be used repeatedly. It is suitable for home use and includes wheelchairs, oxygen equipment, and hospital beds. (DME), which Medicare Part B covers. For coverage, your health care providerA person or organization that’s licensed to give health care. Doctors, nurses, and hospitals are examples of health care providers. must prescribe it.2Medicare.gov, “Hospital beds”, Accessed December 21, 2021
Under Original MedicareOriginal Medicare is private fee-for-service health insurance for people on Medicare. It has two parts. Part A is hospital coverage. Part B is medical coverage., your cost for a hospital bed at home is 20 percent of the Medicare-approved amountA Medicare-approved amount is what Medicare will pay for a covered service. Healthcare providers that agree to Medicare assignment accept the approved amount without excess charges. What Does Medicare-Approved Amount Mean? A Medicare-approved amount is.... Medicare pays for DME in different ways. In many cases, you will need to rent the equipment. In some cases, you can choose if you want to rent or buy.2Medicare.gov, “Hospital beds”, Accessed December 21, 2021
Medicare will only cover your hospital bed if your doctors and supplier are enrolled in Medicare. If your doctors and supplier aren’t enrolled, Medicare won’t pay their claims.2Medicare.gov, “Hospital beds”, Accessed December 21, 2021
If suppliers are participating suppliers, they must accept assignmentAn agreement by your doctor to be paid directly by Medicare, to accept the payment amount Medicare approves for the service, and not to bill you for any more than the Medicare deductible and coinsurance.. That simply means they can charge you only the coinsuranceCoinsurance is a percentage of the total you are required to pay for a medical service. and Part B deductible for the Medicare‑approved amount. If your supplier isn’t participating and doesn’t accept assignment, they can charge you any rate they choose, and you are responsible for the excess.2Medicare.gov, “Hospital beds”, Accessed December 21, 2021
Medicare and Hospital Bed Rentals
For expensive DMEs such as hospital beds, you will most likely rent the bed for as long as your condition requires it. Medicare will provide coverage for your hospital bed for up to 13 months of continuous use. Once you have paid your equipment rental bill for 13 months, you will own the rented equipment.3Medicare.gov, “Medicare Coverage of Durable Medical Equipment & Other Devices”, Accessed December 21, 2021
What Types of Hospital Beds Does Medicare Cover?
Medicare does not specify any limitations on the type of hospital bed that can be covered, so you could get any hospital bed covered as long as your doctor approves it as medically necessary. The greatest impact on a hospital bed’s price is how many electronic features are built into it:4Payingforseniorcare.com, “Paying for Home Hospital Beds: Medicare’s Policy & Financial Help”, Accessed December 21, 2021
- Manual Hospital Beds: start at $500 and use a hand crank to adjust the height and angles of the bed.
- Semi-Electric Hospital Beds: start at $1,000 and use a hand crank to adjust the height, but the head and foot angles are electronically adjustable.
- Full-Electric Hospital Beds: start at $2,000 and are fully adjustable beds, only needing a button press or two.
- Air-Fluidized Bed: average around $55,000 and uses pressurized air to evenly distribute a person’s weight, making it feel like they are floating5Rehabmart.com, “HydroAire Air Fluidized Therapy Bed”, Accessed December 21, 2021.
Other aspects that can impact the final price of the hospital bed include:4Payingforseniorcare.com, “Paying for Home Hospital Beds: Medicare’s Policy & Financial Help”, Accessed December 21, 2021
- Whether you rent or buy the hospital bed
- Bed size, ranging from standard to king size
- Weight capacity
- Special hospital bed sheets and mattress pads
- Trapeze bars, for moving into or out of the bed
- Side rails
- Attached IV poles
The cost of a hospital bed can vary between $500 and over $55,000 depending on the features and accessories you need that are listed above. After Medicare coverage, you would be looking at $100 to $11,000 in out-of-pocket costs, which depends on the type of hospital bed you require.4Payingforseniorcare.com, “Paying for Home Hospital Beds: Medicare’s Policy & Financial Help”, Accessed December 21, 20215Rehabmart.com, “HydroAire Air Fluidized Therapy Bed”, Accessed December 21, 2021
Do Medicare Advantage Plans Cover Hospital Beds?
Just like Original Medicare (Part AMedicare Part A is hospital coverage for Medicare beneficiaries. It covers inpatient care in hospitals and skilled nursing facilities. It also covers limited home healthcare services and hospice care. and Part B), your Medicare Advantage plan covers hospital beds and other DMEs you need. However, that is where a lot of the similarities end.6Medicare.gov, “How do Medicare Advantage Plans work?“, Accessed December 21, 2021
The actual out-of-pocket costs will vary depending on the Medicare Advantage plansMedicare Advantage (MA), also known as Medicare Part C, are health plans from private insurance companies that are available to people eligible for Original Medicare (Medicare Part A and Medicare Part B). in your area. Your DME suppliers will also be restricted to in-networkDoctors, hospitals, pharmacies, and other healthcare providers that agree to health plan members' services and supplies at a set price are in-network providers. With some health plans, your care is only covered if you get... suppliers, so you will need to contact your Medicare Advantage plan provider to find out where you can get a covered hospital bed, as well as how they handle replacements and repairs for broken equipment.3Medicare.gov, “Medicare Coverage of Durable Medical Equipment & Other Devices”, Accessed December 21, 2021
If you have a Medicare supplementMedicare Supplements are additional insurance policies that Medicare beneficiaries can purchase to cover the gaps in their Original Medicare (Medicare Part A and Medicare Part B) health insurance coverage. plan that covers the Medicare Part B coinsurance, it will pick up its share of your out-of-pocket costs for a hospital bed and other Medicare-approved DMEs. So while you may have more to pay each month, you could save a great deal of money if you end up needing a high-cost hospital bed. Medigap policies are available for purchase through many private insurance companies and help you with Original Medicare’s out-of-pocket costs, including:7Medicare.gov, “What’s Medicare Supplement Insurance (Medigap)?“, Accessed December 6, 2021
- DeductiblesA deductible is an amount a beneficiary must pay for their health care expenses before the health insurance policy begins to pay its share.
- CopaymentsA copayment, also known as a copay, is a set dollar amount you are required to pay for a medical service.
Yes, Medicare will cover the cost of your hospital bed purchases and rentals if your doctor says it is necessary. So if you are worried about paying $2,000 after coverage for a hospital bed, Medicare will cover your rental costs at a significantly lower cost overall for as long as you need it. If you are a Medicare Advantage Plan member, please don’t forget to check with your plan provider about how they handle replacements if your hospital bed gets damaged.
- 1CMS.gov, “Medicare Coverage Issues Manual”, Accessed December 21, 2021
- 2Medicare.gov, “Hospital beds”, Accessed December 21, 2021
- 3Medicare.gov, “Medicare Coverage of Durable Medical Equipment & Other Devices”, Accessed December 21, 2021
- 4Payingforseniorcare.com, “Paying for Home Hospital Beds: Medicare’s Policy & Financial Help”, Accessed December 21, 2021
- 5Rehabmart.com, “HydroAire Air Fluidized Therapy Bed”, Accessed December 21, 2021
- 6Medicare.gov, “How do Medicare Advantage Plans work?“, Accessed December 21, 2021
- 7Medicare.gov, “What’s Medicare Supplement Insurance (Medigap)?“, Accessed December 6, 2021