The best-value lift chairs range in price between $300 and $800, with more expensive models going for much more. This is a cost than many retired people cannot afford.
In this guide, we cover everything you need to know to answer the question "Does Medicare cover lift chairs?", including whether you qualify for Medicare assistance for a lift chair, and how much the program will pay. (Note that your doctor has to prescribe the lift chair before you can begin the Medicare approval process.)
If you or someone you love would benefit from a lift chair, this article will walk you through the process of qualifying through Medicare and finding a Medicare-approved provider.
Does Medicare Cover Lift Chairs?
Yes, Medicare covers part of the cost for lift chairs for eligible recipients.
Medicare Lift Chair Requirements
In order to receive reimbursement for the lift mechanism of a lift chair, you must purchase the right type of chair and meet the eligibility requirements, described below.
Note that if you can successfully transfer from the lift chair to wheelchair, Medicare may not consider the equipment a medical necessity. also, Medicare will not pay for lift chairs for recipients living in hospice, a skilled nursing facility or a nursing home.
What Is the Lift Mechanism That Medicare Will Pay For?
Medicare won't pay for the entire chair which includes the fabric and other portions of the recliner. Instead, Medicare pays for the motor and device that actually lifts the seat. Know that Medicare doesn't pay for spring devices designed to lift you out of a seat.
Medicare pays for 80% of the motorized device. That means that you would pay the remaining 20% plus the cost of the chair not covered by Medicaid.
Criteria for Seat Lift Mechanism Reimbursement
The Medicare coverage applies to recipients with Medicare Part B or a Medicare Advantage Plan (Part C). If you have Part C, talk to your private insurance provider about lift chair coverage.
Certificate of Medical Necessity
In order to qualify for lift chair coverage, you have to start by making a doctor’s appointment. Talk to your doctor about writing a prescription for a lift chair. This is the first step in determining medical necessity. The doctor will need to complete parts B and D of Medicare form CMS-849. This form is also called the “Certificate of Medical Necessity for Seat Lift Mechanisms form.”
Determining Medical Necessity
If the following conditions apply, you may be eligible for Medicare lift chair coverage:
Order the chair from a participating Medicare-approved supplier in order to receive reimbursement.
How Often Does Medicare Pay for a Lift Chair?
Medicare will pay for a lift chair mechanism whenever a Medicare recipient meets the eligibility needs and purchases the chair through a Medicare-approved supplier.
How Much Does Medicare Cover for a Lift Chair?
Medicare only covers the seat lifting mechanism. It doesn’t pay for the whole chair. Depending on the state you live in, the reimbursement amount may be around $300, and you would have to pay the rest. For most people with Part B Medicare coverage, that means paying 20% of the approved amounts when buying from a Medicare supplier.
Medicare Lift Chair Form - Where to Download It
To purchase your lift chair from a Medicare supplier, you will probably pay for the chair up front and then fill out the paperwork for partial reimbursement. If you have used a Medicareapproved supplier, they may file the claim on your behalf. If you need to fill out the claim yourself, you can do so online.
In order to complete the claim, you will need some information. So, it's a good idea to gather the following items together:
You have up to 12 months to file the claim or to ask your lift chair supplier to do so.
Medicare Lift Chair Reimbursement - How to Get Reimbursed
Here are additional details about the doctor evaluation and prescription needed to receive reimbursement for your lift chair. Your doctor will write the prescription if they feel that without it you may be confined to the chair or bed.
Lift chairs are typically approved for patients with muscular dystrophy, severe arthritis and neuromuscular diseases. However, your doctor will help you determine whether you are eligible for this benefit.
Your doctor will fill out the relevant sections of CMS-849, the same form you need to complete and file to receive the reimbursement.
How to Get a Lift Chair Through a Medicare Advantage Insurance Plan
If you have a Medicare Advantage Plan, your plan will probably have guidelines for purchasing and getting approval for a lift chair. Contact your agent or the customer service number for your private insurance provider. Now, you are ready to look for a qualified supplier!
Where Can I Buy a Lift Chair Through Medicare?
It's relatively easy to find a Medicare lift chair provider. These providers have already gone through the Medicare approval process, and you can find them on the link mentioned in the next section. By taking the time to choose your provider prior to shopping, you can save time, stress and frustration.
Which Stores Carry Medicare Lift Chairs? Medicare-Approved Lift Chair Dealers
First, it's important to remember that your reimbursement for a seat lift mechanism may vary from state to state. It may also differ slightly depending on which supplier you choose. How much Medicare pays for depends on which state you live in and the company that supplies the chair.
Refer to the Medicare supplier directory to search for a DME supplier. Select “Seat Lift Mechanisms” and choose providers with an “M” symbol. Other providers may not accept payment through Medicare.
At this point, you have a list of stores that you can contact or visit to choose a lift chair with the approved equipment.
How To Get a Lift Chair Through Medicare Step By-Step
Follow the step-by-step process below as well as the tips above to find if you are eligible for a seat lift mechanism reimbursement and where to obtain one.
- 1Visit your doctor to determine if you have a medical condition that necessitates a lift chair mechanism. Your doctor must fill out a certificate of medical necessity for a seat lift mechanism, CMS-849, for you to qualify for Medicare reimbursement.
- 2Next, follow the steps above to select a Medicare supplier located near you.
- 3Ask your supplier to help you fill out the rest of the form so that you can expedite your reimbursement.
- 4Keep in mind that you will probably have to pay out of pocket to receive your chair.
- 5Once approved, Medicare will reimburse you for the covered amounts.
Does Medicaid Pay for Lift Chairs?
Yes! Keep reading to find out how.
How to Get a Lift Chair Through Medicaid
Do you find it difficult or impossible to get out of a chair unassisted due to a physical limitation? A lift chair can help you stand up or sit back down without assistance. In some cases, Medicaid may help you pay for this important mobility tool.
Remember that Medicaid varies drastically from Medicare. For example, Medicaid is a state-run program, whereas Medicare is a federal government program administered by individual states. For Medicare, this means that your eligibility can vary widely depending on where you live.
The easiest way to determine your eligibility is by visiting your state's Medicaid website. Refer to the Medicaid State by State Directory for the relevant contact list. This list has the contact information as well as the telephone number for you to get the information you need. When you speak to someone, let them know that you want to apply for lift chair reimbursement.
If you schedule an appointment, make sure to bring proof of income, a photo ID and a copy of your insurance policy. You will also need a letter or prescription from your doctor indicating that a lift chair can help you retain independence. Since procedures vary for every state, it's important to write down all the paperwork you'll need to complete the application and receive partial or full reimbursement for a lift chair.
It's important to ask all the questions that you may have at the meeting. For example, find out how long the application and approval process typically takes.
Free Lift Chairs for Veterans - How to Get One
In some cases, the Veterans Administration may reimburse you for the motor for a lift chair. ‘ll have to check with the VA in your region. For the most part, though, although the VA pays for chairlifts on stairs and wheelchairs, it doesn't appear to cover lift chairs.
Does Insurance Cover Lift Chairs? What You Need to Know
We've already discussed private insurance that individuals may have through Medicare Plan B. However, we haven't yet discussed whether private insurance may cover the cost of this important mobility device.
If you have a private insurance policy through an employer or self-funded account, it's important to discuss your coverage with your agent. Alternatively, you can call your insurance company directly to find out what mobility assistance devices your policy may cover.
In certain circumstances, private insurance companies may pay to rent or buy a lift chair. Some only partially cover lift chairs while others fully cover them. Still others don't cover the cost at all. So, this really is a case-by-case basis.
Free Lift Chairs - Other Ways to Get a Free Lift Chair
Reach out to one of the organizations below to see if you may qualify for a free lift chair.
Research in your area may uncover other organizations that have charitable programs that offer lift chairs at low or no cost to older adults who need them the most.
What Should You Do Next?
So, now you have a thorough understanding of how to reach out through Medicaid to seek reimbursement for a lift chair device. If you haven't already done so now is a great time to make an appointment with your doctor to find out if you're eligible for a lift chair prescription.
On the other hand, if you have already discussed the matter with your doctor, you can get started filling out the paperwork and shopping for a lift chair. Be sure to use one of the Medicare-approved suppliers in the links provided in the article.
If you aren't eligible for Medicare but have private insurance, find out if your policy covers the cost of lift chairs. Additionally, check with the Veterans Administration if you have served in the military to find out if you're eligible for any other mobility devices. We have also identified three organizations that help seniors obtain mobility devices to help them gain the independence available with a lift chair!