Madicare can pay for your mattress and home medical equipment: unexpected things covered by insurance

Medicare covers the cost of certain types of medical equipment for home use: the list includes wheelchairs, walkers, hospital beds and even mattresses.

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Durable medical equipment (DME) is equipment that helps you do your daily activities. It includes various items such as walkers, wheelchairs, oxygen tanks, mattresses. Medicare usually covers DME if the equipment:

• durable, that is, able to withstand repeated use;
• serves for medical purposes;
• suitable for use at home, although you can also use it outside the home;
• and will probably last three years or more.

To be covered by Part B, DME must be prescribed by your primary care physician (PCP). If you are in a skilled nursing facility (SNF) or inpatient care, DME is covered by Part A.

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Whether you are a member of the program Original Medicare or plan Medicare Advantage, the types of equipment covered by Medicare must be the same. Examples of DMEs include:

• wheelchairs;
• walker;
• hospital beds;
• portable oxygen equipment.

In the Durable Medical Equipment, Prostheses, Orthopedics and Supplies (DMEPOS) category, Medicare Part B also covers:

• prostheses that completely or partially replace the internal organs of the body;
• prostheses such as artificial legs, arms and eyes;
• orthopedic products such as rigid or semi-rigid leg, arm, back and neck braces;
• some medical supplies.

Medicare also covers some prescription drugs and supplies you use with your DME, even if they are single use or can only be used once. For example, Medicare covers medicines used with nebulizers. Medicare also covers lancets and test strips used with diabetes self-diagnosis equipment.

Medicare can even pay for your new mattress, reports TomsGuide.

Choosing the best mattress is especially important as you get older, as it can help reduce pain as well as ensure a good night's rest. It is for this reason that many older adults or people with certain medical conditions choose to invest in a specialized mattress that can offer more personalized support.

The downside is that these mattresses can be expensive, so it's worth knowing that Medicare will cover most of the cost of certain mattresses.

What types of mattresses does Medicare cover?

Medicare has certain guidelines that must be followed before your mattress can be covered. First, the mattress must qualify as DME.

To qualify, a mattress must:

• be durable and able to withstand repeated use;
• used only for medical reasons;
• be useful only to the sick or wounded;
• be used in a person's home;
• serve at least three years.

Reduced pressure mattresses, which are used for certain conditions such as sciatica and arthritis, are usually the only type of mattress covered by Medicare. Some of the best Medicare-approved pressure relief mattresses are listed below:

Mattress Solace Resolution Glissando Heavy Duty: This mattress prevents friction and shear, which helps prevent ulcers. It features high density foam for comfort and integrated sidewalls.

Pressure relief mattress Joerns PrevaMatt Defend: Designed to distribute pressure evenly, this mattress can help prevent a number of problems, including bedsores. Buyers can choose between flat or sidewalls, and each mattress comes with a XNUMX-way stretch nylon topper.

Support mattress Drive Medical Therapeutic: This therapy mattress provides a comfortable sleeping surface by using a pleated top to evenly distribute weight across five zones or areas. Its waterproof and antimicrobial coating is designed for easy cleaning.

Pressure relief mattress ThevoRelief: Specially designed for people with arthrosis, body aches and other discomforts, this mattress features unique wing-shaped hangers that create a soft and comfortable sleeping surface. It gently stimulates nerve pathways while you sleep, helping to reduce soreness.

Mattress system Drive Medical with variable pressure and low air loss: this mattress can operate in both variable and static pressure modes and is designed to prevent and treat pressure sores. There are various settings to suit a person's comfort level.

What types of mattresses are not covered by Medicare?

While some mattresses will be covered by Medicare, many other mattresses will not. If the mattress you are buying is for non-medical use and if it is not being used for specific health problems such as sciatica and arthritis, you will not be able to get financial assistance from Medicare.

Remember that Medicare will only cover mattresses that meet DME criteria and the conditions above.

How much does Medicare cover?

You will need to check your specific Medicare coverage to determine how much Medicare will cover and how much you will need to contribute. However, since mattresses are covered by Medicare Part B, in most cases Medicare will cover 80% of the cost of your new mattress and you will have to pay the remaining 20%. A deductible will also apply, which is $233 in 2022.

Who is eligible for a Medicare-covered mattress?

To be eligible for Medicare assistance, you need to get a doctor's recommendation that you have a medical condition that requires you to purchase a pressure-reducing mattress to relieve discomfort. The note will need to explain what condition you are in and how a mattress can improve your health.

After you receive a doctor's note, you will need to send it to Medicare for review. If Medicare approves the request and agrees that you are eligible, you can proceed and complete the purchase. Another condition is that the mattress must be purchased from a Medicare-approved mattress retailer. If this is not the case, you will not receive your funds. You can search for approved suppliers on the website Medicare.

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To find out if Medicare covers the equipment or supplies you need, or to find a DME provider in your area, call 1-800-MEDICARE or visit medicare.gov. You can also find out about DME Medicare coverage by contacting The program State Health Insurance Assistance (SHIP).

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