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More than 55 million people are enrolled in Medicare. This national social insurance program has been offering health care benefits to those 65 years old and above since 1966.
Medicare benefits are categorized into four parts – A, B, C, and D. For medical coverage, you’ll need to opt for parts A and B. Together, they’re known as Original Medicare. In this case, Medicare will cover up to 80 percent of the cost of your medical bed.
In this post, we’ll cover more about Medicare coverage for hospital beds. Read on to learn more.
Understand Durable Medical Equipment
According to Medicare, durable medical equipment (DME) is any equipment that provides therapeutic benefits to a patient. The equipment is usually prescribed by a doctor for the patient to use at home.
As such, a bed is considered a DME, and only a doctor can prescribe one for a patient. In this case, you may need to buy or rent the equipment. Ths program allows you to choose whether to buy or rent.
So, if you want medical beds for larger persons, it helps to learn more about DMEs covered by Medicare. This is important especially when you want DME for traveling or home use.
Are All Enrollees Covered?
As noted before, DME is only accessible to patients enrolled in part B. Plus, the program will only cover the bed if your DME supplier and doctors are enrolled in Medicare.
There are strict requirements that DME suppliers and doctors must meet. Also, they must be willing to stay in the program. If they aren’t enrolled, any claims they submit won’t be paid by Medicare.
As such, before you get any DME, be sure to ask your doctor and supplier if they’re in the program. Keep in mind that there are suppliers who enrolled but they’re not participating in Medicare. In this case, the may choose not to supply the bed.
When Does Medicare Cover Beds
There are specific cases under which your Medicare plan covers your medical bed for home use.
You must have a condition that needs precise body positioning. This means that it’s only in that position that you can relieve pain or prevent a respiratory condition. Typically, the hospital bed should prevent something that an ordinary bed can cause or worsen.
Also, you must have a medical problem that needs special attachments. This can be traction equipment or other tools that can’t be affixed to an ordinary bed. Also, Medicare may pay for additional bed attachments that are necessary for treating your condition.
Bear in mind that Part A covers the bed if you’re an inpatient or in a skilled nursing facility (SNF).
The Cost of Buying or Renting a Bed
As noted before, your part B plan covers 80 percent of the medical bed’s costs. This is applicable only after you’ve met your Part B deductible. The overall cost usually ranges from $500 to $5,000. Your specific cost will depend on the size and features of the bed.
Typically, you have to pay 20 percent of the approved amount when renting or buying a bed. If you have supplemental health insurance, you can cut yours out of pocket costs.
Keep in mind that you can only enjoy reduced cost if your supplier accepts the assignment. A hospital bed is usually in the capped rental category. In this case, you can rent the bed first and choose to buy it after ten months. Medicare usually makes a 10-monthly rental payment.
Your supplier will send you a letter of the purchase option. You’ll have 30 days to respond. If you want to buy the bed, Medicare will make three payments, and you get the bed. You’ll be responsible for maintaining the bed, but Medicare will also cover some of the maintenance costs.
If you’re not interested in buying, Medicare will make more 15 payments. Under the current Medicare rules, you can own the bed after renting for 13 months.
Understanding Grandfathered Supplier
A grandfathered supplier is simply a supplier that doesn’t get Medicare contracts. In this case, the supplier must be “grandfathered” if they wish to continue renting the medical bed to you.
This is usually the case for those patients that were renting beds before the program started. However, if you choose to rent a bed from a grandfathered supplier after the start of the program, Medicare won’t cover the costs.
In some cases, your supplier may decide not to become a grandfathered supplier. Here, you can choose to continue using the supplier and pay all the costs. Or, you can switch to a Medicare contract supplier. The supplier will notify you and pick up the bed from your home before the program starts.
Your supplier must notify you within 30 days before the start of the program. If you switch a supplier, the old supplier must work with the current one to ensure there is no break in service.
Competitive Bidding Program
Certain areas are subject to Medicare’s Competitive Bidding Program. In this case, if you live or visit the competitive bidding areas, suppliers must bid to provide the medical bed.
Medicare reviews all the bids and uses them to determine the amount for the bed. During the review, all the suppliers are evaluated to ensure they meet all the requirements. They must meet the quality, financial, eligibility, and accreditation standards.
If you live in these areas and you have Original Medicare, the Competitive Bidding Program requires you to get the bed from a contract supplier. The good thing is that the program doesn’t limit your choice of the doctors.
Keep in mind that the bidding program only applies to enrollees of Original Medicare (Parts A and B).
Medical Bed – Final Thoughts
If your condition requires a bed and you’re covered by Medicare, it helps to understand all the requirements. The most important is that you’re an enrollee of Original Medicare. Plus, you must work with doctors and suppliers who are participating in the program.
Be sure to contact a Medicare administrative contractor in your state. They can help with bills for DMEs, and they’ll also give you a list of approved suppliers of beds.
If you have any thoughts about a medical bed, be sure to share them with us in the comments.