Does Medicare Cover Lift Chairs for the Elderly?

Lift chairs assist individuals who have difficulty standing from a seated position. These motorized recliners gently raise users, aiding mobility and independence. Medicare has specific guidelines for Durable Medical Equipment (DME), which includes certain aspects of lift chairs.

Medicare’s Stance on Lift Chair Coverage

Medicare Part B generally covers only the lifting mechanism component of a lift chair. This motorized part is recognized as Durable Medical Equipment (DME) because it is designed for repeated use, serves a medical purpose, is used in the home, and is expected to last for at least three years. However, Medicare does not cover the chair’s frame, upholstery, cushions, or any additional features like heat or massage. Coverage for the lifting mechanism is contingent upon a physician deeming it medically necessary for the patient’s condition, meaning it must be required to diagnose or treat an illness, injury, or disease, and meet accepted medical standards.

Qualifying for Medicare Coverage

To qualify for Medicare coverage of a lift chair’s lifting mechanism, specific medical criteria must be met, and a detailed doctor’s prescription is required. A physician must determine that the patient has severe arthritis of the hip or knee, or a severe neuromuscular disease, which prevents them from rising independently from a regular chair. The patient must also be able to walk once standing, either independently or with an assistive device like a walker or cane, as Medicare does not cover the device if the patient transfers directly to a wheelchair. The prescription must be a written order, including the patient’s diagnosis, the medical need for the device, and a description of the specific equipment. The lift chair must be obtained from a Medicare-enrolled supplier that accepts assignment.

Navigating the Coverage Process

After medical necessity criteria are met and the prescription obtained, securing Medicare coverage involves working with a Medicare-approved Durable Medical Equipment (DME) supplier. The supplier typically handles billing directly with Medicare. When a supplier accepts assignment, they agree to accept the Medicare-approved amount as full payment for the lifting mechanism, billing the beneficiary only for applicable deductible and coinsurance amounts. After the claim is submitted, Medicare processes it, and the beneficiary receives a Medicare Summary Notice (MSN) detailing services billed, Medicare payments, and amounts owed.

Your Out-of-Pocket Costs

When Medicare covers the lifting mechanism of a lift chair, beneficiaries are responsible for out-of-pocket costs, including the annual Medicare Part B deductible, which is $257 in 2025, before Medicare pays its share. After the deductible, Medicare pays 80% of the approved amount for the lifting mechanism, leaving the beneficiary responsible for the remaining 20% coinsurance. The cost of the chair’s non-lifting components, such as upholstery or extra features, is not covered by Medicare and is the beneficiary’s sole responsibility. Medigap plans may help cover the 20% coinsurance, and Medicare Advantage (Part C) plans also cover medically necessary DME, though beneficiaries should consult their plan for specific cost-sharing and network requirements.