Are Stair Lifts Covered by Medicare?

Stair lifts offer a means for individuals to navigate multi-level homes when mobility becomes a challenge. Many people exploring this solution often inquire about coverage through Medicare. Original Medicare, which includes Part A and Part B, generally does not cover stair lifts. This is because Medicare classifies them as home modifications, not durable medical equipment (DME), which falls outside its typical coverage. This article explains Medicare’s criteria for covered equipment and explores other financial assistance avenues.

Medicare’s Criteria for Durable Medical Equipment

Medicare covers medical supplies and equipment only if they meet specific Durable Medical Equipment (DME) criteria. To qualify as DME, an item must withstand repeated use and serve a medical purpose, addressing an illness or injury rather than providing convenience. It should not be useful to someone who is not sick or injured. The item must be appropriate for home use, though its use is not exclusively limited to the home. It must also be expected to last for at least three years.

Medicare also requires that DME be prescribed by a physician or authorized healthcare provider. This prescription must document the medical necessity of the equipment for the beneficiary’s condition. The supplier providing the DME must also be enrolled in Medicare for the costs to be covered.

Stair Lifts and Medicare Part B

Medicare Part B covers Durable Medical Equipment (DME). Despite covering various mobility aids like wheelchairs, walkers, and hospital beds, Part B generally does not cover stair lifts. This exclusion stems from Medicare categorizing stair lifts as home modifications or accessibility improvements, rather than medical equipment directly treating an illness or injury.

Since the device is attached to the home’s structure, Medicare considers it a permanent alteration to the property. Medicare’s policies explicitly exclude coverage for home modifications, regardless of whether they improve safety or accessibility.

While stair lifts can significantly enhance independent living in a multi-level home, they do not meet Medicare’s strict definition of DME. Beneficiaries with Original Medicare will typically find stair lifts are not covered expenses.

Medicare Advantage Plans and Stair Lifts

Medicare Advantage (MA) plans, also known as Medicare Part C, are offered by private companies approved by Medicare. These plans provide at least the same coverage as Original Medicare, but often include additional benefits. This expanded scope can sometimes cover items not included by Original Medicare.

Some MA plans may offer supplemental benefits that assist with home modifications or safety equipment, including a portion of stair lift costs. This is not a universal offering; coverage varies by plan and geographic location. Since 2019, MA plans have had greater flexibility to offer non-medical benefits, including home modifications, if they improve or maintain health or function.

Beneficiaries interested in potential stair lift coverage must review their plan’s specific benefits. They should confirm if modifications are included, along with eligibility requirements and any annual or lifetime benefit limits. Coverage for stair lifts through these plans remains uncommon and is often limited to specific situations, such as for individuals with chronic conditions.

Medicaid and State-Specific Programs

Medicaid is a joint federal and state program providing health coverage to individuals and families with limited income and resources. Unlike Medicare, Medicaid can be a viable avenue for covering stair lifts, particularly through Home and Community-Based Services (HCBS) waivers. These waivers allow states to offer services that help individuals remain in their homes and communities, avoiding institutional care. If a stair lift is deemed medically necessary to allow an individual to remain safely in their home and prevent institutionalization, Medicaid’s HCBS waivers may cover its purchase and installation.

Each state administers its own Medicaid programs and waivers, so eligibility criteria and covered benefits can vary. Individuals typically need to meet income and asset limits, as well as a defined level of care (often equivalent to nursing home care), to qualify for these waiver programs.

Beyond Medicaid, some states and local entities offer non-Medicaid programs or grants assisting seniors or individuals with disabilities with home accessibility modifications. These programs might be administered by state departments of health, aging, or housing, or through local Area Agencies on Aging. Funding availability and eligibility requirements for these programs differ widely by location, often considering income, assets, and physical needs.