Does Medicare Cover a Bedside Commode?

Medicare can provide coverage for a bedside commode under specific conditions. This coverage aims to support individuals who require assistance with toileting due to medical necessity within their home environment.

Medicare Coverage for Bedside Commodes

Bedside commodes are categorized by Medicare as Durable Medical Equipment (DME). DME includes items that are durable, serve a medical purpose, are for use in the home, and are expected to last for at least three years. Original Medicare Part B covers DME, including bedside commodes, when medically necessary. A bedside commode is a portable toilet positioned near a bed to aid toileting.

Eligibility and Medical Necessity

For Medicare to cover a bedside commode, a physician or other healthcare provider must issue an order for the equipment. The primary criterion is medical necessity, meaning the beneficiary must be physically unable to use a standard toilet. This inability might stem from being confined to a single room, restricted to one level of a home without a toilet, or confined to the home with no toilet facilities. The commode must be for use in the beneficiary’s home.

The medical need must be documented in the patient’s record, detailing why the commode is necessary for diagnosis, treatment, or to improve functioning. For instance, Medicare covers heavy-duty commodes if a beneficiary weighs 300 pounds or more, or commodes with detachable arms if needed for transferring. Obtain the equipment from a Medicare-enrolled supplier, as Medicare will not cover items from non-enrolled suppliers.

Steps to Obtain a Bedside Commode

Beneficiaries should discuss their needs with their physician or healthcare provider. The physician will provide a written order for the bedside commode. This order must include information explaining why the commode is medically necessary based on the beneficiary’s specific limitations.

After obtaining the physician’s order, find a Medicare-approved Durable Medical Equipment (DME) supplier. Beneficiaries can use the Medicare.gov Supplier Directory tool or call 1-800-MEDICARE to locate approved suppliers. Confirm the chosen supplier is enrolled in Medicare and accepts “assignment.” Accepting assignment means the supplier agrees to accept the Medicare-approved amount as full payment, limiting the beneficiary’s out-of-pocket costs to the deductible and coinsurance.

Your Financial Responsibility

Even with Medicare coverage, beneficiaries are responsible for out-of-pocket costs. For Original Medicare Part B, the annual deductible must be met before Medicare begins to pay its share. In 2025, the Medicare Part B annual deductible is $257. After the deductible is satisfied, Medicare typically covers 80% of the Medicare-approved amount for the bedside commode. The beneficiary is then responsible for the remaining 20% coinsurance.

Medicare Advantage Plans (Part C) are required to provide at least the same coverage as Original Medicare Part A and Part B, including DME. However, Medicare Advantage plans may have different cost-sharing structures, including varying deductibles, copayments, and coinsurance for DME. Beneficiaries with a Medicare Advantage plan should contact their plan directly to understand their specific costs and network requirements. Medigap policies, also known as Medicare Supplement Insurance, can help cover some out-of-pocket costs associated with Original Medicare, such as deductibles and coinsurance.