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Related Primary Content:
The majority of good mattresses aren't covered by Medicare so your best bet is to avoid them completely.
Usually, they're nothing more than a thin piece of foam that is not a better option than a camping mattress. Medicare considers electric beds as "convenience devices" and thus does not cover them. Medicare may however cover pressure-relieving and adjustable beds.
If you are unsure whether you need a hospital bed, it is always better to consider a direct-to-consumer mattress.
Related Secondary Content:
What Types Of Mattresses Are Covered By Medicare?
Medicare covers only a limited number of mattress types. They might cover the cost of a pressure-relieving mattress if your doctor writes a note explaining why you need one.
Most Medicare beneficiaries cover mattresses that qualify for DME designation and meet the criteria. DME mattresses are designed for people who are bedridden for months or years and need the functionality of a hospital bed. Most are foam or innerspring models under $500, with some adjustable air models over $4,000.
Medicare will likely cover the cost of a simple hospital bed mattress unless there is documented harm associated with it. Coverage for a "low air loss mattress" will require documentation of issues such as bed sores, skin breakdown, and decubitus.
How Much Of The Mattress Purchase Will Mediocare Cover?
For a good consumer mattress that isn't a hospital bed? Likely $0. Consumer mattresses that aren't hospital beds rarely qualify for Medicare coverage.
Medicare Part B covers 80 percent of the cost of an approved mattress (usually a hospital bed).
Medicare Part C plans have provider networks and may have copayments. They may also have different fees than Original Medicare. Again, this doesn't include good consumer mattresses that are comfortable, sturdy and built to last.
Are Adjustable Bases And Hospital Beds Covered By Medicare?
It's unlikely that Medicare will cover adjustable bases and hospital beds.
Medicare covers medical equipment purchases from an approved supplier, but electronic beds and other features may not be covered.
When Medicare does not cover all of your expenses, Medigap plans may be able to help you. Many Medigap plans are worth buying if you need extra help with expenses.
You can apply for Medicare coverage for pressure-reducing mattresses if your doctor issues an order for them.
Should I Buy A Normal Mattress If It'S Not Covered By Medicare?
Absolutely. The longer you wait for Medicare approval (which is very unlikely to begin with), the longer your problems persist.
We recommend choosing a high-end consumer mattress, like the Saatva Classic, right away.
Skip the hassle of having to deal with medicare and simply buy your best consumer option available to you, now.
Can Medicare Cover The Cost Of A Replacement Mattress For A Hospital Bed?
Medicare can cover the cost of a medically necessary mattress for a hospital bed if it is prescribed by a doctor to treat or prevent a medical condition such as bed sores or pressure ulcers. However, Medicare usually only covers the cost of a basic hospital bed mattress and not a specialized or luxurious one. If you need a replacement mattress, talk to your doctor or healthcare provider to determine if it is necessary and to obtain a prescription. You should also confirm with your Medicare provider to learn about any out-of-pocket costs. If Medicare does not cover the replacement mattress, explore various brands and models on the market that are suitable for your needs and budget. When shopping, consider factors such as size, firmness, and material to ensure the necessary support and comfort.