Will Medicare Pay for a Lift Chair in 2024?
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August 23, 2024
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Medicare Coverage of Lift Chairs
- As of 2024, Medicare Part B will pay for some of the costs for a lift chair, as it qualifies as durable medical equipment.
- Medicare will only pay for the lifting device, not the chair itself, and the lift chair will have to be prescribed by a doctor and provided by a company enrolled in Medicare.
- Your Part B deductible and coinsurance will apply here; however, some Medigap policies can cover these costs. To find a Medigap policy that will cover Part B costs, read our guide to this year’s best Medigap providers.
For qualifying individuals, Medicare will cover a percentage of the cost of a lift chair, as these are considered durable medical equipment. With that said, Medicare only covers items it deems medically necessary –– in this case, the lift hardware, which typically costs about $500. Medicare will not cover the seat portion, even though it's built into the chair.
What Is a Lift Chair?
Lift chairs, which look quite similar to traditional recliners, help users shift from a seated to a standing position at the press of a button. As the seat rises on an incline, its angle eases its occupant to a standing or seated position. Some lift chairs come with extra comforts such as heating and massage. Others allow users to recline to a fully flat position, making it easier to sleep or relax.
Commonly Confused Words: Be careful not to confuse a lift chair with a stair or patient lift. Stair lifts securely transport you from one level of your home to another, using a chair designed to slide from top to bottom of the stairs and vice versa. Patient lifts help older adults move from their bed to a chair, or usually a wheelchair.
Who Would Benefit From a Lift Chair?
Ideal for older individuals who struggle with balance, mobility, or pain, lift chairs can help those with trouble sitting or standing up. They’re especially helpful for those with muscle or joint disorders and people recuperating from surgeries.
Does Medicare Cover Lift Chairs?
While Medicare provides coverage for lift chairs, it does not cover all costs related to the chair. Coverages vary based on the type of Medicare you’re enrolled in. Furthermore, Medicare solely contributes to paying for the costs of the chair’s lifting device, not its fabric, cushions, accessories, or extra upgrades. This is because these parts of a lift chair are not considered medically necessary.
Medicare Advantage providers (private insurance companies you select in place of traditional Medicare) are required by law to provide the same benefits as Medicare, if not more. As such, you can expect comparable lift chair reimbursement options. Additionally, every type of coverage has specific stipulations attached regarding eligibility for lift chair reimbursement.
What Qualifies as Durable Medical Equipment?
Lift chairs are classified as durable medical equipment or DME. DME is essential equipment you repeatedly use for medical purposes at your home for 3-plus years. Better-known examples of DME include walkers, portable oxygen concentrators, hospital beds, wheelchairs, and blood sugar meters.
Cost of Lift Chairs Through Medicare
Lift chairs can be expensive, typically ranging from $400 to $2,000 depending on the supplier and any additional features. Median lift chair costs are about $700.
There’s good news, though. If you have a prescription and purchase through a Medicare-participating supplier, you should be reimbursed for 80 percent of the cost of the chair’s motorized lift. This usually reduces your overall cost by about $300, meaning your out-of-pocket costs for a lift chair could potentially be as little as $100. If you purchase a chair at the median $700 price point and receive the average $300 reimbursement, the total cost will be approximately $400. If you have any additional insurance or discounts, these may help lower your final cost as well.
Remember, you must meet your Medicare Part B deductible before Medicare begins paying 80 percent for approved products and services. If you haven’t already reached your deductible, expect to pay $226 in 2023 before you receive your 80 percent coverage.
Lift Chair and Medicare Eligibility for Coverage
Eligibility for Medicare Part B coverage of a lift chair involves several requirements:
- You must be over the age of 65 and enrolled in Medicare.
- Your doctor must provide you with a prescription for the chair.
- You and your physician must complete the government form dictating the medical necessity of a lift chair. The yes or no questions on the form help administrators determine whether your eligibility will be approved. Your doctor will also fill out a section that describes your need in a narrative form.
- Your purchase must take place through a Medicare-approved supplier.
- You must not live in a nursing home or other in-patient facility.
Also, If Medicare has previously paid for another motorized device, such as a mobility scooter or wheelchair, chances are it won't cover a lift chair.
How to Pay for a Lift Chair Through Medicare
Use the step-by-step process detailed below as a guide to ensure reimbursement for your lift chair through Medicare.
Medicare Part B Coverage
Obviously, securing the right coverage is the first step before purchasing a lift chair that Medicare will reimburse you for. This includes enrolling in Medicare Parts A and B, paying your monthly premiums, and meeting your annual deductible.
Once you meet your $203 deductible, Medicare Part B will cover 80 percent of Medicare-approved DME purchases. In the case of a lift chair, this means Medicare will reimburse you for 80 percent of the cost for the lifting tool that the lift chair uses. Unfortunately, the government does not consider the chair portion of a lift chair to be medically necessary, which means you’ll be financially responsible for the cost of the actual chair and 20 percent of the cost for the lifting system.
Medicare-Enrolled Physicians
Work with your Medicare-enrolled physician to determine whether or not a lift chair is a medically necessary step for you or your loved one. If you decide to move forward with purchasing a lift chair, make sure you get a prescription and fill out and submit a Certificate of Medical Necessity for Seat Lift Mechanisms Form with your provider.
Medicare-Participating Suppliers
As you shop around for your lift chair, ensure you ask all potential sellers whether or not they are a Medicare participating supplier. If they are not, Medicare will not reimburse you for the lifting device. You may want to start your search by entering your ZIP code on Medicare’s page for medical equipment and suppliers to avoid any problems down the road. Once you’ve found a Medicare-approved vendor that offers the chair you want, double-check its approval and go ahead and make your purchase.
Reimbursement
In most cases, you’ll need to purchase your lift chair upfront and then submit all the required information to Medicare for reimbursement. Medicare will approve your eligibility after confirming that your prescription dictates the chair’s medical necessity and that you’re using a Medicare-participating supplier. After all, you don’t want to find out you’re not eligible for reimbursement after you’ve paid for the chair, had it delivered, and gotten used to it.
Once you’ve made your purchase, most Medicare-approved sellers will submit a claim to Medicare for you. However, you can also submit it yourself. Claims submitted online are processed more quickly and can take as few as 14 days. Typically, all claims will process in about 30 days.
Getting Started
While Medicare won’t cover the entire cost of your lift chair, it can certainly be a helpful way to offset the high price tag. Be sure to obtain your prescription and save your receipts to ensure you’ll receive the reimbursement you deserve.
To learn more about Medicare coverage of treatments and equipment, check out our helpful guides:
Medicare and Lift Chair Frequently Asked Questions
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How do I get Medicare to pay for a lift chair?
Eligibility for Medicare coverage of a lift chair requires a medical necessity prescription and confirmation that you’ve purchased your lift chair from a Medicare-approved supplier.
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Does Medicare pay for sleep chairs?
Since Medicare considers a sleep chair, also known as a lift chair, durable medical equipment, Medicare Part B should cover part of your costs for the chair.
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Will Medicare pay for a transport chair?
Medicare will pay up to 80 percent of the cost for the motorized lift portion of a lift chair as long as you have a prescription from a Medicare-enrolled physician and purchase it from a Medicare-approved vendor.
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How much does a lift chair cost?
Lift chairs cost anywhere from $600 to about $2,000, depending on the brand, vendor, and the specific qualities of the chair.
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Can you convert a recliner to a lift chair?
Universal lifts, which Medicare sometimes covers, do exist. These lifts, such as EhanSit, sell for approximately $500. If you already own a solid recliner, these lifts can save you out-of-pocket costs for the chair.