Will medicare pay for power lift chair

Many people experience mobility issues later in life, making it difficult to care for themselves in their homes. One of seniors' most common problems is getting up and down from a standing or sitting position. While it may seem like a simple task, it might be too much for someone struggling with arthritis, a mobility-limiting surgery, or even just old age.

That’s where a lift chair can help. These motorized devices help those with mobility issues move between sitting and standing. A lift chair can make a difference in allowing someone to live independently in their own home. However, they are costly. The good news is that if you have Medicare, your plan may cover some of the lift chair cost.

Key Takeaways

• A lift chair is a motorized device designed to help someone move between a sitting and standing position.
• Medicare Part B covers lift chairs as long as they are deemed medically necessary and are prescribed by a doctor.
• Medicare covers 80% of the cost of durable medical equipment, including lift chairs, while patients cover the other 20%.
• To qualify for a Medicare-covered lift chair, you must get a prescription from a doctor and work with a Medicare-approved supplier.

What Is a Lift Chair?

A lift chair looks like a recliner, but the chair’s base contains a motorized device that raises and lowers the seat when needed, making it easier for someone to move between sleeping, relaxing, sitting, and standing. Some chairs can angle your legs or feet above your torso or head.

These devices may also be called reclining lift chairs, motorized recliners, and power lift recliners. Lift chairs come in various fabrics, sizes, and with and without headrests. Some chairs even offer heat and massage inside the chair’s mechanisms.

Lift chairs can be helpful in many situations, but doctors often prescribe the chairs for severe arthritis in the knee or hip, or for neuromuscular disease. Lift chairs can be classified as an FDA Class II Medical Device, and can also be used by those who otherwise couldn’t stand up or would be confined to a chair or bed.

A lift chair works on command, meaning someone can use it independently. As a result, these devices make it easier for individuals to live independently in their homes rather than having in-home care or moving into a nursing home or assisted living facility.

Note

Despite the similar name, a lift chair isn’t the same thing as a stair-lift chair. A stair-lift chair transports someone up and down a staircase, allowing them to live in a multistory home.

Will Medicare Pay for My Lift Chair?

Medicare Part B—known as medical insurance—covers medically necessary services and supplies, including durable medical equipment. Durable medical equipment includes just about any piece of equipment a doctor might prescribe for a medical condition, including lift chairs.

A lift chair must be medically necessary and prescribed by a doctor for costs to be covered by Medicare. A physician must indicate that one of the following is true for you (or a parent):

• Severe arthritis of the hip or knee
• Severe neuromuscular disease
• Complete incapability of standing up from a regular armchair or any chair in the home but can ambulate after standing

The form also asks the physician to indicate whether appropriate therapeutic techniques (e.g., medication and physical therapy) have been tried, failed, and documented to enable the patient to transfer from a chair to a standing position.

Depending on the situation, Medicare may either rent or buy your lift chair, or give you the option to buy or rent. Generally, Medicare only purchases inexpensive items such as canes, walkers, and more. However, for equipment needed for long-term use, Medicare may start off renting it, then eventually purchase it.

If Medicare covers your lift chair, you will still have some out-of-pocket costs. First, you’ll have to meet your deductible for the year. In 2022, the Medicare Part B deductible is $233. After meeting your deductible, Medicare Part B covers 80% of the Medicare-approved amount, while you’ll pay the other 20%.

Suppose you’ve been approved for a lift chair, and the Medicare-approved cost is $1,000. You’ve already hit your deductible for the year, meaning you’re only left with your coinsurance. You pay 20% of the purchase, which equals $200, while Medicare pays for the other $800.

Of course, your costs could look different if you have a Medicare Advantage plan instead of Original Medicare. Because each Medicare Advantage plan is private, costs can vary when it comes to deductibles and coinsurance.

How To Get Your Lift Chair Covered

To have your lift chair covered by Medicare, your doctor must write a prescription stating it’s medically necessary based on the criteria we listed above. Your doctor must also complete the Certificate of Medical Necessity: CMS-849 - Seat Lift Mechanisms.

Parts of the form must be completed by the patient, the doctor, and the supplier. The doctor will have to certify that the device is medically necessary. The supplier must describe the item, item charge, and the Medicare Fee Schedule Allowance for each item, accessory, and option.

Note

For your lift chair to be covered, the prescribing doctor must accept Medicare, and the supplier must be approved by Medicare.

Where To Get an Approved Lift Chair

Medicare maintains a database of approved durable medical equipment and suppliers, which makes it easy to find one in your area. Simply input your zip code and the terms “seat lift mechanisms” or “seat lift.” The Medicare website will show you a list of nearby suppliers carrying chairs with a seat-lift mechanism.

You’ll next need to contact the supplier to find out which lift chairs it stocks and if it agrees to accept the Medicare-approved amount as full payment. If not, you may need to pay some amount out of pocket for your lift chair.

Your doctor may also be able to recommend a supplier. The chances are that your doctor has had to prescribe lift chairs to other patients, and their office may be able to coordinate care with the supplier.

Frequently Asked Questions (FAQs)

How much are lift chairs?

Lift chair costs range from $600 to $2,700, with most above $1,000. Rental may be around $150-$500 per month. Prices vary depending on your supplier and the chair's features, and you might have to pay shipping or delivery fees. Remember, your out-of-pocket costs should be limited to 20% of the Medicare-approved amount if the chair qualifies.

What durable medical equipment does Medicare cover?

Medicare covers a wide range of durable medical equipment that is medically necessary. These supplies meet accepted standards of medicine and are needed to diagnose or treat an illness, disease, injury, condition, or its symptoms. The list includes (but isn’t limited to) the following: hospital beds, blood sugar monitors and test strips, canes, commode chairs, crutches, scooters, infusion pumps, wheelchairs, oxygen equipment, and walkers.