Paying for Home Hospital Beds: Medicare's Policy & ...

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Page Reviewed / Updated &#; January 20,

Joshua Iversen, President, Syzygy Financial LLC

Expert Reviewed By:

Medicare&#;s Policy on Home Hospital Beds

Basic home hospital beds may be paid for, in part, by Medicare Part B. Anyone who has Medicare Part B, and has a medical need for a hospital bed in their home, is able to get partial coverage under Medicare&#;s Durable Medical Equipment (DME) policy. DME is defined as medical equipment that can be reused, and a hospital bed falls under this policy. A Medicare enrolled doctor must deem the hospital bed necessary and prescribe it for use in an individual&#;s home.

Medicare will pick up 80% of the amount that is Medicare approved for the purchase of a hospital bed for home use. The individual must cover the remaining 20%. This can be paid out-of-pocket or with help from supplemental insurance, such as Medigap. One must also have met their Medicare Part B deductible, which as of is $185. Medicare will also help to cover the cost of some bed accessories, which may include trapeze bars, mattress covers that are intended to avoid bedsores, and bedside rails.

Rather than buy a home hospital bed straight out, one can also rent a hospital bed and still receive financial assistance from Medicare. With current Medicare regulations, after 13 months of renting, the individual owns the bed.

It&#;s important to note, Medicare will not cover the cost of full electric beds. However, one can pay the difference out-of-pocket between a manual-lift bed and a fully electric one. In addition, Medicare only covers a basic bed, meaning a shape very similar to a twin bed, but not identical.

In order for Medicare to pick up part of the bill, an individual must get the hospital bed from a Medicare approved supplier. If the hospital bed is purchased from a supplier that is not approved, Medicare won&#;t cover any of the cost of the hospital bed. Participating suppliers have Medicare supplier numbers. To find participating suppliers, click here or call 1-800-633-. 

Medicare Advantage Plans, such as a PPO or HMO, may also help to cover the cost of hospital beds. Since plans vary, one will need to call their provider and ask about their specific plan. It is very likely their policies will be the same as Medicare&#;s policy.

Financial Assistance & Payment Options

Medicaid

Since Medicaid is a joint federal and state program, with each state running the program as they see fit within the guidelines set forth by the federal government, rules and regulations about durable medical equipment (DME) such as home hospital beds, is not consistent across the states. That being said, each state has a Medicaid State Plan and most states also have Home and Community Based Services (HCBS) Medicaid Waivers. Both State Plans and Waivers provide assistance to help the elderly avoid nursing home placement. Therefore, Medicaid very often will cover the cost of DME, which includes home hospital beds. As with Medicare, the bed must be deemed necessary by a physician. Learn more about Medicaid and their stance on DME here. 

State Funded, Non-Medicaid Programs

Some states offer non-Medicaid assistance in obtaining durable medical equipment and hospital beds for home use for aging or low income residents. However, it&#;s important to note that these programs vary widely across the board. Click here to learn more about these programs and to see if one is available in your state.

Veterans Options

The Department of Veterans Affairs (VA) offers medical benefits for veterans that also include covering DME, such as home hospital beds. However, once again, a doctor must deem the bed medically necessary.

TRICARE for Life (TFL), a supplemental medical insurance for retired veterans, helps to cover the costs for those enrolled in Medicare that are not covered by Medicare. This holds true for DME, as TFL will pick up the 20% copayment that Medicare requires when purchasing DME. CHAMPVA for Life (CFL) offers the same benefit. But it is meant for spouses at least 65 years of age of vets who have been permanently disabled or killed in service. TRICARE, also for retired vets, also covers hospital beds (both rented and purchased), given they have been prescribed by a doctor.

There are other avenues in which a veteran can get a home hospital bed should a family feel one is required, but is not able to get a prescription. The Veteran-Directed Home and Community Based Services Program (VD-HCBS) allows participants control over what care and services meet their needs. This program should give veterans the flexibility to purchase a hospital bed even if they are unable to have one officially prescribed.

Another option is the Aid & Attendance (A&A) Program. This is a pension program for veterans who need help with their activities of daily living. Their care requirements do not need to be related to their military service. Under A&A, monies can be allocated as the beneficiary sees fit.

In addition, many states also have programs specifically for veterans. For instance, Project MEND is for residents of Texas and provides refurbished home hospital beds and mattresses to veterans and their spouses.

Tax Deductions

One may make a deduction from their federal income taxes in the event they buy a needed home hospital bed for themselves, their spouse or other dependent. It&#;s important to note that deductions for durable medical equipment can only be made in the year that they were purchased. The following examples presume the tax filer has no other medical expenses for the year.

The tax filer can deduct the cost of the bed that is over 10% of their adjusted gross income. If part of the bed was covered by insurance, the tax filer would only be able to deduct the part that was paid out-of-pocket.

Example: Carol&#;s adjusted gross income is $20,000. 10% of $20,000 is $2,000. She purchased a hospital bed for $3,000 out-of-pocket. Therefore, she can deduct $1,000 from her federal taxes.

Example: John has an adjusted gross income in the amount of $15,000. Medicare picked up $2,400 of a $3,000 bed, leaving John $600 to pay (the 20% co-payment). 10% of $15,000 is $1,500. Therefore, since the portion of the hospital bed John has to pay is not over 10% of his adjusted gross income, he cannot deduct this amount from his federal taxes.

Non-Profits & Charities

Depending on the area in which one resides, there may be non-profits and charitable organizations that give away or loan home hospital beds. For instance, the Muscular Dystrophy Association has an equipment loan program. It includes home hospital beds for those who have neuromuscular diseases, such as ALS. To learn more, click here. 

For more information on non-profit organizations that provide DME, click here. 

Home Hospital Bed Costs

The cost of a home hospital bed ranges from $500 to $10,000. The variance is largely due to features and size.

Feature Impacting Price

Electric vs. Manual
Manual Hospital Beds &#; Hospital beds that are manual are the most basic hospital beds and are adjusted via a hand crank. This crank is either attached to the head or the foot of the bed, depending on the model. This type of bed is the most affordable option, which generally starts at about $500.

Semi-Electric Hospital Beds &#; Semi-electric beds offer more convenience than do manual beds, making it much easier for one to move the position of the bed. With this type of bed, one is able to move the head and foot of the bed electronically, but still has to manually adjust the height of the bed via a crank. The price of a semi-electric bed generally starts at approximately $1,000.

Full-Electric Hospital Beds &#; Full-electric beds offer the ultimate in convenience since all movements / adjustments are made electronically. However, this type of hospital bed is the priciest, starting at around $2,000.

Bed Dimensions 
The length of a standard hospital bed from the top of the bed to the bottom of the bed is 38&#; width by 84&#; length, with the sleep surface being 36&#; width by 80&#; long. However, there are extension kits to extend the length of some hospital beds by 4&#;, which is ideal for persons that are taller than 6&#;. There are also full size hospital beds, which are 54&#; wide by 80&#; long, queen size beds that are 60&#; wide by 80&#; long, and king size beds that are 76&#; wide by 80&#; long. In addition, there are also bariatric beds that come in a larger width of 48&#;. Of course, the larger one goes in size, the more the bed will cost.

Weight Bearing
Most home hospital beds can accommodate weight up to 450 pounds. For individuals who weigh more than this, a bariatric bed is required, which can hold up to 1,000 pounds. Bariatric beds are generally full-electric beds. In general, bariatric beds can cost as much as three times more than standard hospital beds. Bariatric beds also require specific sheets and mattress pads.

Bed Sheets 
Home hospital beds require sheets that are specifically made for this type of bed. This is because a typical hospital bed is the size of a twin bed in width, but is longer in length. One should expect to pay approximately $50 for a set of sheets for a standard home hospital bed.

Mattress Pads 
Home hospital beds also require mattress pads that are specifically made for home hospital beds. A variety of different types of mattresses are available for purchase, including air, gel, and foam. Also, some serve specific purposes, such as adding comfort and helping to prevent sores from body pressure. One can find basic mattress pads starting at approximately $100.

Trapeze Bars 
These bars are used to assist individuals in switching positions, whether it be repositioning to get more comfortable or offering assistance in getting in and out of bed. Bars add $100 &#; $200 in cost.

Rails 
Both manual and electronic rails are available for purchase. One should expect to pay an additional $75 &#; $400.

IV Poles 
For those who require an IV pole, there are both IV poles that attach to hospital beds and freestanding IV poles. One should expect to pay approximately $50.

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Others
Other add-ons for home hospital beds include bed trays, table trays, bedpans, call cords, and bed rail pads.

Purchasing Used Home Hospital Beds

Used hospital beds are available and can save one a significant amount of money. In fact, one can purchase a used hospital bed starting at approximately $300. While one can purchase used hospital beds from websites such as Ebay and Craigslist from private owners, these hospital beds generally will not come with any sort of warranty. Many dealers sell refurbished beds, which typically come with a 3-month to 1-year warranty. Make note, used bariatric beds are more difficult to find than standard home hospital beds.

Renting Home Hospital Beds

Renting a home hospital bed (manual, semi-electric, and full-electric) is a great option for those who will only need it for a limited period of time. This is a much more cost efficient option for short-term use. On average, it costs one $200 &#; $500 / month to rent a home hospital bed. One can also find mattresses for rent. Some companies that rent home hospital beds may charge an initial fee for set-up. If this is the case, one should expect to pay an additional $50 to $100.

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Manufacturers

To assist in one&#;s search for home hospital beds, below is a list of reputable manufacturers.

• Drive
• DRE
• Hill-Rom
• Invacare
• Medline
• Stryker

We may use a few terms in this article that can be helpful to understand when selecting the best insurance plan:

This article looks at Medicare coverage requirements. It also examines the costs and financial assistance.

For people with certain medical conditions, such as a broken hip or paraplegia, an adjustable bed can mean greater comfort and a lower risk of further injury.

Medicare covers different types of durable medical equipment (DME), which may include an adjustable bed if a person meets the criteria.

In general, doctors do not consider an adjustable bed useful or necessary for a person who is not sick or injured. According to Medicare&#;s definitions, lounge beds &#; whether they use manual or electric power &#; are not DME.

However, there are different types of adjustable beds, and Medicare does not cover them all. For Medicare to consider an adjustable bed as DME, the bed must:

Medicare considers prescribed adjustable beds, including hospital beds , as DME. Therefore, it may cover the cost as long as a doctor certifies that a person needs the bed for home use.

Part B also covers some medical testing and some medications, such as infusions or vaccinations.

Medicare divides its coverage into parts, with each part offering coverage for different aspects of healthcare.

Medicare may cover part of the cost for necessary modifications to a person&#;s adjustable bed, such as having an air-fluidized bed for reducing pressure. Other Medicare-covered adjustments may include :

The bed should also have side rails that an individual can lower or raise.

Medicare will only consider an adjustable bed as DME if it adjusts either from the head or foot, allowing a person to elevate different body parts as necessary.

Examples of conditions for which people may need an adjustable bed include:

In the prescription, the doctor must describe the person&#;s condition and diagnosis to explain why the adjustable bed is medically necessary.

According to the eligibility requirements , the bed is a medical necessity if a person needs:

For someone to be eligible for an adjustable bed that qualifies as DME, their doctor must write a prescription stating that the bed is medically necessary.

Although Medicare helps pay for adjustable beds, a person is usually still responsible for paying a portion of the costs. Various factors can also affect the costs, such as the type of bed and the rental or purchase terms.

Purchase or rental

The person must rent or buy the bed from a supplier that accepts Medicare assignment. This means the supplier agrees to the price Medicare sets for renting or purchasing the equipment.

If someone purchases or rents a bed from a supplier that does not accept Medicare, that supplier may charge more than the Medicare-approved amount, and Medicare will not cover the cost.

If a person rents the bed, Medicare covers the monthly payments, and the supplier covers the cost of repairs. Medicare will cover the rental costs for 13 months of continuous use. After this time, the supplier must transfer ownership to the user.

To find a supplier, a person can use Medicare&#;s online tool or call 1-800-MEDICARE (1-800-633-).

Types of bed

Many different adjustable beds are available, with various options for purchase or rental.

Cost factors will include:

• the model of the bed, including whether it is electric or manual
• inclusion of extras, such as mattresses or railings
• rental versus purchase

Medicare coverage

After a person&#;s doctor certifies that a bed is medically necessary and the person obtains it from a Medicare-approved supplier, they will pay 20% of the Medicare-approved amount.

If a person has not met their Medicare Part B deductible, it will apply to the purchase or rental. For , the Medicare Part B deductible is $257.

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