Does Medicare Cover Hospital Beds for Home Use?

Medicare, a federal health insurance program, helps millions of older adults and certain younger people with disabilities afford healthcare services and supplies. It is designed to provide coverage for various medical needs, ensuring beneficiaries have access to necessary care. This program plays a significant role in managing healthcare expenses for eligible individuals across the country.

Medicare Coverage for Hospital Beds

Medicare covers hospital beds for home use when they are considered medically necessary, classifying them as Durable Medical Equipment (DME) under Medicare Part B. DME includes items that can withstand repeated use, are primarily for medical purposes, not useful without illness or injury, and suitable for home use. For an item to qualify as DME, it must also be expected to last for at least three years. Hospital beds meet these criteria, making them eligible for coverage under the program.

Meeting Coverage Requirements

For Medicare to cover a hospital bed, specific conditions demonstrating medical necessity must be met. A doctor’s order or prescription is required, clearly documenting how the bed will treat or manage a patient’s specific medical condition. Examples of conditions that often establish medical necessity include the need for specific body positioning to alleviate pain, prevent bedsores, or manage respiratory issues like chronic obstructive pulmonary disease (COPD) or severe cardiac conditions that require the head of the bed to be elevated more than 30 degrees. The bed may also be deemed necessary if it facilitates transfers for individuals with severe arthritis, lower extremity injuries, or spinal cord injuries, or if it is required for attaching traction equipment.

The supplier providing the hospital bed must be enrolled in Medicare and agree to accept assignment. A doctor’s comprehensive notes in the patient’s medical records are essential, detailing the diagnosis and symptoms that necessitate the hospital bed. Thorough documentation within medical records, beyond just an order form, is required to support the claim for coverage.

Steps to Get a Covered Hospital Bed

To obtain a Medicare-covered hospital bed, begin with your healthcare provider. Work closely with your doctor to ensure that the medical necessity for the hospital bed is thoroughly documented in your medical records. The doctor will then issue a prescription or written order for the bed, specifying how it addresses your medical condition. This documentation is fundamental for Medicare approval.

Once you have the doctor’s order, find a Durable Medical Equipment (DME) supplier approved by Medicare. The official Medicare website offers a supplier directory where you can search for approved providers in your area by entering your zip code. Confirm that the chosen supplier is enrolled in Medicare and accepts assignment. The supplier will typically handle the process of filing the claim with Medicare on your behalf, streamlining the administrative burden.

Understanding Your Costs

When Medicare covers a hospital bed, beneficiaries are responsible for a portion of the cost. After meeting the annual Medicare Part B deductible ($257 in 2025), beneficiaries typically pay 20% of the Medicare-approved amount, with Medicare covering the remaining 80%. This cost-sharing arrangement applies whether the equipment is rented or purchased, depending on Medicare’s rules for the specific item.

Accepting assignment by the supplier directly impacts your out-of-pocket expenses. When a supplier accepts assignment, they agree to accept the Medicare-approved amount as full payment for the equipment. This means they cannot charge you more than the deductible and 20% coinsurance. Working with a supplier who accepts assignment helps control your costs and ensures that you are not billed for amounts exceeding Medicare’s approved rates.