Did you know that Medicare might cover the price of your new mattress or bed if it meets certain requirements? When you are over the age of 65 and have chronic pain, postural or mobility issues, or any medical conditions that may affect your sleep, the right mattress can greatly improve your health. The problem is that mattresses tend to be expensive. Here are some tips to find out if Medicare may cover the cost of your mattress.
We know that finding a mattress that provides both support and comfort is a tough challenge, and that it is even harder to find one that might be covered by Medicare. That is why we’re here to help. Only some types of mattresses are covered by Medicare, and only some Medicare plans might cover the price of a mattress. So, knowing what will qualify you for Medicare mattress coverage, and where to start is important. We’ll point you in the right direction.
What Is Medicare?
Medicare is a medical insurance program administered by the United States government, which essentially covers those over 65 and the disabled, regardless of their declared income. [1]
In Medicare you can enroll for a part called A (hospital insurance) and a part called B (medical insurance). If you do not register for part B from the 3 months prior to the age of 65 until the 3 months following that date, you will pay the penalty, which consists of 10% per year for each year in which you do not register. In addition to parts A and B there are two other parts: part C, known as Medicare Advantage, which offers health care plans managed by private insurance companies recognized by Medicare. These plans bring benefits to parts A and B and their services and contribute to the payment of prescription drugs. Part D, on the other hand, contributes to the payment of the costs of the drugs, lowers the costs of the prescribed drugs and protects against the increase in the cost of these drugs.
Your key to a Medicare-covered mattress is through Medicare Part B (Medical Insurance). Medicare Part B only covers certain services, including visits to the doctor, outpatient care, preventive services, and medical supplies. Certain mattresses can count as durable medical equipment, one of the types of medical supplies that Medicare Part B may cover.
What is Durable Medical Equipment?
Durable Medical Equipment is equipment that must meet certain criteria and has to be prescribed by your doctor. It must first be durable, meaning that it can withstand repeated use and has an expected lifetime of 3 or more years. It also has to have a medical purpose and be useful only for someone who is sick, injured, or otherwise disabled. Finally, durable medical equipment has to be something that is used in the home. The supplier and the doctor who prescribes the equipment must be enrolled in Medicare.
If you’re worried about whether Medicare can cover equipment like that, or adjustable beds, you don’t have to be worried anymore. The answer to, ‘Does Medicare cover adjustable beds?’, is a resounding yes. Under Part B, it’s classified as medical equipment. The basic coverage here will cover a basic hospital bed. If your doctor orders extra features like adjustable height features, an electric-powered bed, and side rails, Medicare will cover twenty percent of the cost of them. Other items that Medicare partially covers for adjustable beds include gel or gel-like pressure mattress pads, synthetic sheepskin pads and lambswool sheepskin pads.
While Medicare does not cover other types of mattresses besides pressure-reducing mattresses, there are plenty of brands of mattresses that fall under this category. Some brands of this type of mattress that Medicare covers include the Solace Resolution Glissando Heavy Duty Mattress, the Joerns PrevaMatt Defend Pressure Relief Mattress and the Drive Medical Therapeutic 5 Zone Support Mattress.
If you think that the mattress you want to get and your circumstances match these requirements, then you may be eligible to apply for coverage of a new mattress. The type of mattress that is eligible for coverage is called a pressure-reducing mattress.
Pressure-reducing Mattresses
If you are wondering exactly how you might be able to get a mattress that is covered by Medicare, you need look no further than a pressure-reducing mattress. In order to have your new mattress covered by Medicare, it needs to classify as Durable Medical Equipment and must be prescribed by your doctor. Pressure-reducing beds, mattresses, and mattress overlays are the only types of bed-related equipment that can be covered by Medicare, and they must meet certain criteria. The most important criteria is that the mattress must serve a medical purpose. If you believe that you might qualify for one of these types of mattresses, you should talk to your doctor and your Medicare rep to see what you might qualify for and how much your insurance might cover it.
How Do I Know if Pressure-reducing Mattress is Best For Me?
The type of mattress you sleep on can have a large impact on many different disorders that commonly affect senior citizens, including sleep disorders like sleep apnea or periodic limb movement disorder, as well as chronic pain, neurological problems, poor bladder control, and gastrointestinal issues, all of which can make it difficult to fall asleep. An adjustable mattress and bed will improve blood circulation and relax muscles. A patient who suffers from upper back and neck pain should consider a plusher bedding that can allow the thoracic area and head, “to sink into the bed to support the cervical area,” according to the website Dynamic Chiropractic.
How do you know if you even need a new mattress? The best answer to this question is that you need to listen to your body. Do you wake up stiff and sore? Does your lower back feel worse in the morning than in the evening? Is your mattress 10+ years old? Do you spend a lot of time in bed and has your doctor suggested that you switch to a pressure-reducing mattress? If so, it may be worth considering a new pressure-reducing mattress, and seeing if Medicare might cover it.
Lastly, try to remember that at the end of the day, there is no perfect mattress. In every mattress you look at you will always find some properties you love, and some other properties that you may not be as fond of. Even so, take the time to check out your options, visit your local mall, search different mattresses online, and explore which type of mattress will be best for you. Make sure to also look into whether your new mattress might be covered by Medicare. Don’t waste another sleepless night on your old mattress. It’s time to get yourself a new mattress and take care of yourself in your golden years.
Even though it can be hard sourcing everything you need, you can do it. To get your adjustable bed and pressure-reducing mattress, you must be enrolled in Medicare Part B. If you’ve already done this, then get your doctor to place an order for the bed, and have a face-to-face visit with them within six months.
[1] Medicare.gov. “What’s Medicare?” Accessed March 18, 2020. https://www.medicare.gov/what-medicare-covers/your-medicare-coverage-choices/whats-medicare
[2] Eleesha Lockett, MS. “Medicare Advantage Plans: What They Cover.” Healthline. October 21, 2019. https://www.healthline.com/health/medicare/what-do-medicare-advantage-plans-cover
[3] Medicare.gov. “Durable Medical Equipment (DME) Coverage.” Accessed March 18, 2020. https://www.medicare.gov/coverage/durable-medical-equipment-dme-coverage