Does Medicare Cover a Recliner Lift Chair?

A lift chair is a specialized recliner designed to assist individuals in safely transitioning from a seated to a standing position. This chair incorporates a motorized mechanism that gently lifts and tilts the base and backrest, helping a person rise without excessive strain. Many individuals with mobility challenges consider these chairs for their home. Medicare can cover such equipment under specific conditions.

Medicare’s Coverage for Durable Medical Equipment

Medicare generally covers Durable Medical Equipment (DME) when it is medically necessary and prescribed by a healthcare provider for home use. DME is reusable medical equipment primarily used for a medical purpose, not typically useful to someone who is not sick or injured, and expected to last for at least three years. Examples include walkers, hospital beds, and oxygen equipment.

Medicare Part B covers DME. For coverage, the equipment must be prescribed by a doctor or other authorized healthcare provider, such as a nurse practitioner or physician assistant. It must also be obtained from a supplier that is enrolled in Medicare.

Specific Medical Requirements for Lift Chair Coverage

Medicare specifically covers only the seat-lift mechanism of a lift chair, not the entire chair, when certain medical criteria are met. For this mechanism to be considered medically necessary, a patient must have severe arthritis of the hip or knee, or a severe neuromuscular disease. The individual must be completely unable to stand from a regular chair in their home without assistance.

Once standing, the patient must be able to walk independently or with a cane or walker. Medicare does not cover the device if the patient transfers directly to a wheelchair, as the purpose of the lift mechanism is to facilitate ambulation. The seat-lift mechanism must be an integral part of the physician’s treatment plan, designed to improve or slow the patient’s condition. It is not covered if solely for comfort or convenience.

How to Obtain a Medicare-Covered Lift Chair

Obtaining a Medicare-covered lift chair involves a clear process that begins with your treating physician. The first step requires a prescription and a Certificate of Medical Necessity (CMN) from your doctor. This CMN, Medicare form CMS-849, must be thoroughly completed and signed by the physician, detailing the specific medical need, diagnosis codes, and confirming that the patient meets the strict medical criteria for coverage.

Once the necessary documentation is prepared, you must select a Durable Medical Equipment (DME) supplier that is enrolled in Medicare. Ensure the supplier accepts Medicare assignment, meaning they agree to accept the Medicare-approved amount as full payment for the covered item. Many Medicare-approved suppliers can assist with submitting the claim to Medicare on your behalf. While some suppliers may require upfront payment, they will then process the claim for reimbursement.

Understanding Your Out-of-Pocket Costs

Even when a lift chair’s seat-lift mechanism is covered by Medicare, beneficiaries are responsible for a portion of the cost. Medicare Part B pays 80% of the Medicare-approved amount for the covered seat-lift mechanism, but only after the annual Part B deductible has been met. For 2025, the annual Part B deductible is $257. After satisfying this deductible, the beneficiary is responsible for the remaining 20% coinsurance.

Medicare’s coverage applies only to the motorized lifting device itself, not the entire chair. The beneficiary will also be responsible for the full cost of the chair’s frame, cushioning, and upholstery. Choosing a supplier who accepts Medicare assignment ensures they will not charge more than the Medicare-approved amount for the covered portion. Supplemental insurance plans, such as Medigap policies or Medicare Advantage plans, may cover some or all remaining out-of-pocket expenses, including the Part B deductible and coinsurance.