Does Medicare Cover Chair Lifts? Top Full Guide 2022

Medicare is an expansive program that provides comprehensive health insurance to millions of seniors and disabled Americans. According to Medicare.gov, Medicare covers many benefits for seniors and those with disabilities such as:

Physical, Occupational, and Speech Therapies
Preventive Medicine
Home Health Care
Home Repair, Maintenance, Modification, or Construction
Medically-Indicated Home Improvements

But Does Medicare cover chair lifts? Read on this article, Focal Upright will provide you with more information that can solve your problems.

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Does Medicare Cover Chair Lifts?

Medicare does provide some coverage for lift chairs, provided a doctor prescribes it for a medical reason. The lift chair’s costs are not covered by Medicare. Motorized lifting mechanisms are Durable Medical Equipment (DME) and are covered by Part B.

Other parts of the chair, such as the frame, cushioning and upholstery, are not covered and will be charged separately.

Durable Medical Equipment must meet these criteria to be eligible for Medicare reimbursement.

Durable (can be used repeatedly)
Required for a medical purpose
Use in the home
Usually lasts at least three years
A person who is injured or ill is often able to use this service.

Durable Medical Equipment also includes crutches and wheelchairs.

The lift chair’s chair section is not medically necessary and therefore it’s not covered.

What Is A Lift Chair?

Lift chairs are chairs that lift you from a sitting position to a standing position. These chairs can be very helpful if you have mobility issues or difficulty standing from a seated position.

Although it looks similar to a reclining chair in appearance, the chair can be raised or lifted on an inclined basis by pushing a button.

Some lift chairs can have heat and massage features. Some chairs may even transform to a completely flat position, which would allow you to sleep in the chair as well.

Lift chairs can be customized with many features and upgraded upholstery materials. Prices are variable. The price range for most chairs is between several hundred and a few thousand dollars.

A lift chair is different from a stair lift, which is a seat that moves you up and down a staircase. The lift chair is not a patient lift. This allows caregivers to transfer you from a wheelchair into a bed or vice versa.

Kinds Of Lift Chairs

Three Types Of Lift Chairs Are Available.

Two-Position Lift chair

This is the most basic of all three.

It can recline in two positions: A 90-degree upright position or a 45-degree position with the individual’s legs elevated and back at a recline.

The leg elevator and the reclining motor form one engine. This allows the chair to elevate as it reclines.

Three-Position Lift chair

The three-position lift chair has a 45-degree reclined and upright angle. It is similar to its two-position counterparts.

The chair’s reclining position allows for a nearly flat angle. The supine position relieves pressure on the back.

The chair’s components are all one motor like the two-position chair.

Infinite Position Lift Chair. The most customizable of the three medicare options, the infinite position chair is the best.

These seats can be used to sit upright or flat. You can also tilt your back at a 45-degree angle and elevate your legs.

Zero-gravity chairs

These zero-gravity chairs are powered by two motors, and they are usually the most expensive option of all three. These chairs are the most versatile of all the lift chairs.

Where To Get Lift Chairs

A Medicare-approved supplier is recommended for you to purchase a lift chair. Contact your local Social Security office to find approved suppliers. The local Social Security office can also provide Medicare beneficiaries with updated listings of suppliers.

Although it is difficult to predict which type of lift chair will be the most expensive, we can say that infinite-position chairs will usually cost the most. Two-position chairs tend to cost less.

Will My Medicare Pay For A Lift Chair?

Yes, Medicare Part B covers lift chairs. These chairs are considered Durable Medical Equipment (DME) and can be used to treat conditions such as arthritis, balance issues, or mobility problems. These standards should also be included in any Medicare Advantage plan. If you are currently residing in a hospital, skilled nursing facility, or nursing home facility, you won’t be eligible for a lift wheelchair. If Medicare has paid for a wheelchair, scooter, or another motorized device, you won’t be eligible.

Medicare pays the piece of equipment that “lifts” you from the seat. Chairs that have a spring device lifting you out of the chair are not covered by Medicare. Even though the device is embedded in the chair, it doesn’t cover the fabric, cushion, or other accessories.

Medicare will cover approximately 80 percent of motorized devices. You will be responsible for the remaining 20% and the cost of the rest of your chair. Supplemental Medigap plans can also cover the cost of all Medicare-inexpensive items. After you have chosen the chair that you like, you’ll purchase it and your provider will submit a Medicare claim.

How Do I qualify For A Lift Chair?

Medicare will pay for a lift chair Medicare may cover the seat lift mechanism of a lift chair if these criteria are met.

Medicare coverage: Medicare Part B (Medical Insurance), or a Medicare Advantage Plan, (Part C) must be in place. Talk to your private insurance company provides to learn about the costs and coverage requirements for obtaining a lift chair if you get your Medicare benefits through Medicare Advantage Plans.

Because Medicare Advantage companies must cover all aspects that original Medicare does, you should get at least the same amount of coverage, if not additional benefits.

A certificate stating medical necessity: To obtain prescription drugs for the lift chair, you must make an appointment with your doctor. Sections B and D must be completed on a “Certificate of Medical Necessity for Seat Lift Mechanisms form,” also known as “Medicare form CMS-849.”

Determining medical necessity: If the following conditions are met, a seat lift mechanism might be considered medically required.

The patient lifts may have severe arthritis in the knee or hips or a severe neuromuscular disease
The patient lift is totally incapable of standing from a regular chair.
Standing, the patient is able to walk independently or with the assistance of a cane or walker. Medicare may not pay for a wheelchair if the patient transfers directly to it.
The physician uses the seat lift mechanism to treat the patient.

Medicare-participating suppliers: You must order your lift chair from Medicare-participating suppliers that accept medicare assignment, otherwise Medicare will not pay for it.

Costs And Reimbursement

Medicare Part B costs

Eligible DME costs are covered under Medicare Part B from an approved provider who accepts assignment. You will first need to pay your annual deductible of $203 by 2021.

After you have met your deductible, you will pay 20% of the Medicare-approved amount for the lifting mechanism. The chair’s remaining cost will be covered by 100 percent.

Medicare-enrolled doctors and suppliers

Medicare will pay only for a lift chair when the doctor who prescribed it is a Medicare provider. Medicare requires that the supplier be enrolled in Medicare.

It is important to check with the company before you shop for lift chairs. You may be charged more if the chair company isn’t enrolled in Medicare. If this happens, it will be up to the customer to pay the difference.

How reimbursement works

You can get partial reimbursement from Medicare if you purchase your lift chair from a Medicare supplier.

If the supplier is enrolled in Medicare, they will typically file a claim for you. Fill out an online claim if the supplier fails to file the claim. These are the items you’ll need to submit a claim:

The claim form
An itemized bill
A letter explaining why you are submitting the claim

Additional documents, such as your prescription from your doctor, that are related to the claim can be attached

You or the supplier must file the claim within 12 months of the purchase of the lift chair.

Considerations

You may be able to rent a lift chair from some companies. This could impact your Medicare costs. It is a good idea to inquire from the company renting your unit about Medicare monthly costs.

A Medigap policy (also called Medicare Supplement Insurance) may be able to help you cover the cost of your copayments for the chair.

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