Does Medicare Cover Lift Chairs?

Coverage depends on the plan you have with Medicare. The essential feature that Medicare will cover is also the chair’s greatest benefit: its lifting mechanism.

Many lift chairs include other features that may either disclude them from being considered medically necessary. The other side of that coin is that these features can increase user-friendliness, extend its use, and promote user satisfaction, but they’re not integral to the lifting function.

You may either have to pay out of pocket or opt for a more flexible plan that would cover the bells and whistles you need.

To qualify for a lift chair, you have to demonstrate a medical need according to Medicare’s own standards. Medicare will only honor its promise to cover the seat lift mechanism of the chair if you can meet their preset criteria.

First, you must be enrolled in and covered by Medicare Part B or Medicare Advantage (Part C) plan. The latter is part of a private insurance provider’s policy so you’ll need to make sure they don’t have any extra coverage rules, costs, and suppliers when getting your lift chair.

To prove that you demonstrate medical necessity, you’ll first need to schedule an in-person appointment with your physician. Your physician will grant you a prescription that states you have a medical condition that requires the use of an at-home lift chair.

Your doctor will also need to fill out sections B and D on the official Certificate of Medical Necessity for Seat Lift Mechanisms form – otherwise known as Medicare Form CMS-849. 

Pro-tip: Check to make sure that you’re purchasing from a Medicare-participating supplier that accepts assignment. Otherwise, Medicare won’t cover the costs.

Once you have the required paperwork completed, you’ll need to send this information to your provider. It’s your provider’s responsibility to submit the claim for your chosen chair to Medicare – but first, you need to demonstrate physical and medical eligibility. 

Original Medicare requires that your doctor and lift chair supplier also be active participants enrolled in Medicare. Medicare has its own set of standards that these suppliers and doctors must meet – so make sure that your physician and supplier are enrolled.

Pro-Tip: Even if a supplier is enrolled in Medicare, they may not be active participants who are accepting assignment. If this is the case and they’re not actively participating, they can choose not to accept your request and can charge whatever they’d like for your DME.

Medicare will pay for your lift chair as long as you meet the criteria for eligibility. Your physician needs to assess you along these criteria because their verification is like a stamp of approval to Medicare. It tells Medicare that you have a legitimate need. 

Medicare Advantage Plans are like your HMO or PPO and give you extended coverage. As of 2019, changes to the provisions of these plans may group lift chairs as an allowable supplemental health care benefit.

These changes make it easier than ever for those with a specific injury or physical and medical need to access lift chairs in a cost-effective way. 

If you don’t have a Medicare Supplemental Plan, you’re not entirely at a disadvantage. The excess charges for features like heat and massage or zero-gravity reclining, or the 20% co-insurance you have to pay may be tax-deductible. 

It’s best to consult a tax specialist, but in general the IRS says that you can deduct a number of qualified medical expenses and a lift chair comes under capital expenses. If you want to claim your lift chair as a tax-deductible expense, make sure to have a prescription from your physician proving medical necessity.

If you’re planning to use Medicare to offset the cost of a lift chair, you should be aware that the Medicare Competitive Bidding program may apply to your purchase. 

It changes the amount of money Medicare pays for DME items according to location. Through this program, suppliers submit bids for DMEs and Medicare then uses these bids to set the amount they’re willing to pay for each item. There is some proof through longitudinal studies that show that this sometimes works in your favor because the competition drives prices of medical equipment down. 

Many older adults and seniors with mobility issues and degenerative bone or neuromuscular conditions see the lift chair as a must-have rather than a nice-to-have. These individuals would both qualify for Medicare and would likely purchase a lift chair regardless of coverage – especially if they have private insurance. 

In other words, the benefits of buying a lift chair often outweigh the consideration of cost. However, if you can ensure savings while still benefiting from an in-home therapeutic solution, you should take advantage of it. 

Medicare’s eligibility criteria and coverage may seem like a lengthy process, but your provider and lift chair supplier can help you go through the paperwork fairly quickly. Along with Part B coverage, you can also take advantage of the tax-deductible nature of medical equipment like lift chairs. 

The key here is to make sure that you’re buying the right model. With your forms filled out, take the time to research the best chair on the market and one that is tailored specifically to your needs. 

Lift chairs are not all created equal. If you experience mobility issues along with other problems like sleep apnea, Restless Leg Syndrome, or sore joints and muscles, you want to focus on a lift chair model like Perfect Sleep Chair — which is designed to address a multitude of symptoms through one design. 

Lift chairs can be an innovative solution for older adults and seniors, but it can also extend its use to the rest of your household. It can easily become one of the ways to age in-home while still remaining safe and comfortable. 

Contact us now at 1-888-317-9131 to find out more about how you can get your Perfect Sleep Chair. It will be the last Lift Chair you ever buy.