Does Medicare Cover Lift Chairs?

What part of Medicare pays for lift chair costs

 A nurse helps an older woman from a chair.
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People experiencing life changes due to age, arthritis, or a mobility-limiting surgery can buy a lift chair for assistance getting up or down from sitting position or standing position.

The high cost of lift chairs can be a significant expense for Medicare beneficiaries. However, Medicare Part B covers lift chairs that a doctor deems medically necessary and prescribes for use in your home. You must satisfy some requirements to have your lift chair costs paid under the durable medical equipment (DME) coverage.

Learn about the benefits of lift chairs, how Medicare covers them, and where to get a Medicare-approved lift chair.

Key Takeaways

  • Medicare Part B covers lift chairs under the durable medical equipment (DME) coverage. Your doctor must prescribe this equipment as a medical necessity.
  • Coverage only pays for the lifting device—not the chair itself and parts such as cushions, fabric, or other aesthetic accessories.
  • Medicare will only cover lift chairs obtained from its suppliers that accept Medicare.

What Is a Lift Chair?

A lift chair is a mechanized chair that aids with standing up and sitting down for people with limited mobility. A physician may prescribe a lift chair for patients with severe arthritis of the knee or hip, patients with muscular dystrophy, and older people whose muscular system is weakened by degenerative joint disease.

With the push of a button, a lift chair hoists a person with limited mobility from sitting to a position where they can comfortably stand up. It also works in reverse to help a person gently take a sitting position.

Medicare coverage for lift chairs is limited to chairs that operate smoothly, that effectively aid in standing up and sitting down, and that a patient can control.

Will Medicare Pay for My Lift Chair?

Medicare Part B will pay some of the costs of your lift chair under the durable medical equipment (DME) coverage. Medicare Part B pays for your lift chair only when your doctor or other health care provider prescribes it for use in home health care. A nursing home or hospital that provides you with Medicare-covered care doesn’t qualify as your home, but a long-term care facility may qualify.

Medicare Part B helps pay for the lifting device rather than the chair itself. As a result, coverage won’t extend to cushions, fabric, or any other chair accessories.

Qualifying for a Medicare-Covered Lift Chair

Prior to 1986, Medicare coverage for lift chairs was restricted to patients suffering from muscular dystrophy, severe arthritis of the knee or hip, or other neuromuscular diseases. In 1986, the Health Care Financing Administration (HCFA) amended its policy to cover lift chairs based on medical necessity instead of diagnostic categories.

The requirements to qualify as a medical necessity are as follows:

  • A physician must determine you can benefit therapeutically from its use.
  • The lift chair is part of the doctor’s course of treatment and will likely support the improvement or slow down the deterioration of your condition.
  • The condition is so severe that the only alternative is confinement in bed or a chair.

Both your doctor and lift chair supplier must be accepted by Medicare. Otherwise, Medicare won’t pay your submitted claim. Medicare-participating suppliers can only charge you the coinsurance and Part B deductible for the DME-approved amount.

There’s no limit to the amount you can pay for durable medical equipment provided by a non-participating supplier. So make sure your doctor and supplier are accepted in Medicare.

What You May Pay Toward a Medicare-Covered Lift Chair

Medicare carriers must ensure that all medical necessity requirements are satisfied before approving payment. Payments are frequently made to the participating supplier, or 80% of the Medicare-approved amount.

You then need to pay the remaining 20% coinsurance after you meet your Medicare Part B deductible for the year. For example, if your doctor prescribed a lift chair and you purchased one for $1,050 from an accepted supplier, Medicare may cover $840 (80%). In this case, if you’d already met your deductible, you’d pay $210 (20%).

The amount you are required to pay may vary since Medicare pays for different types of DMEs in different ways. Depending on the equipment, you may need to rent it, purchase it, or have the choice to either rent or buy.

If you've accepted a Medicare Advantage plan and need a lift chair, call your plan’s primary care provider to find out whether your plan will provide the DME. Medicare Advantage plans must cover medically necessary items and services just as Medicare Part A and Part B do.

If your Medicare Advantage plan doesn’t cover a DME item or service you deem necessary, you can appeal the denial of coverage and have your request reviewed by an independent party.

If you’re receiving home care or using medical equipment and have accepted a new Medicare Advantage plan, call your new primary care provider to ensure coverage will continue for the DMEs or services you’re using.

How To Get Your Lift Chair Covered

For Medicare to cover your lift chair, your doctor or treating physician must prescribe it by filling out an order stating that the equipment is medically necessary. Your doctor typically fills out a Certificate of Medical Necessity, which has questions aimed at demonstrating your medical need for the equipment.

Your supplier follows up with your doctor to ensure the form is submitted to either Medicare or your Medicare Advantage provider. Your doctor must complete and submit a new, updated order should your condition or needs change in the future.

Medicare will only cover lift chairs obtained from a Medicare-accepted supplier. Suppliers must be approved by Medicare and have a Medicare supplier number.

Where To Get an Approved Lift Chair

You can get an approved lift chair by searching through the Medicare Supplier Directory, which has information about suppliers who provide durable medical equipment in the U.S. Enter your ZIP code and choose “patient lifts” to find an approved supplier in your area.

Suppliers must satisfy strict qualifying standards to get a Medicare supplier number. Some questions to ask when choosing a supplier may include:

  • Do you have a Medicare supplier number?
  • Do you accept Medicare assignment?
  • Will you bill Medicare for me?

Anyone who carries Medicare Part B can get a lift chair as long as it’s a medical necessity. Medicare Advantage plans may also cover lift chairs, but you must call your plan’s primary care provider to get DME coverage.

Repair and maintenance requirements for durable medical equipment also vary depending on whether you own or rent the equipment. If you own the DME, your supplier has no obligation to offer repair services. However, your supplier must repair and maintain the equipment if you’re renting it.

Frequently Asked Questions (FAQs)

How much are lift chairs?

Lift chairs often may cost between $600 and $2,000, although prices vary by supplier and quality of materials you choose, among other features.

What durable medical equipment does Medicare cover?

Some of the durable medical equipment Medicare covers include hospital beds, traction equipment, walkers, crutches, blood sugar meters, and patient lifts. Visit Medicare.gov for a complete list of the durable medical equipment Medicare covers.