Does Medicare Cover Recliners for Seniors?

Medicare is a federal health insurance program primarily for individuals aged 65 or older, and younger people with certain disabilities. It helps manage healthcare costs, which can become substantial with age or illness. While many assume Medicare covers all medical needs, its coverage for items like recliners is not always straightforward and depends on specific criteria and equipment type.

Medicare Coverage for Durable Medical Equipment

Standard recliners, designed for comfort or convenience, are generally not covered by Medicare. However, Medicare does cover certain medically necessary items categorized as Durable Medical Equipment (DME). DME is durable, withstands repeated use, serves a medical purpose, is appropriate for home use, and is expected to last for three years or more.

Medicare Part B, which covers medical insurance, includes DME coverage. For an item to be covered, a healthcare provider must prescribe it, stating it is medically necessary for use in the home. Common examples of DME covered by Medicare include wheelchairs, walkers, hospital beds, and oxygen equipment.

Specific Coverage for Lift Chairs

While typical recliners are not covered, a specific medical recliner known as a lift chair may qualify for Medicare coverage under precise circumstances. A lift chair includes a motorized mechanism that helps individuals transition from a sitting to a standing position. Medicare’s coverage for lift chairs is limited to this lifting mechanism itself, not the entire chair, including its frame, cushioning, or upholstery.

To be considered for coverage, an individual must meet strict medical necessity criteria. This includes having severe arthritis of the hip or knee, or a severe neuromuscular disease. The individual must also be completely unable to stand up from a regular chair without assistance.

The lift mechanism must be prescribed by a physician as part of a treatment plan to improve the patient’s condition or to prevent its deterioration. It is also required that the individual can operate the lift mechanism independently or with minimal assistance and can walk once standing, even if using a cane or walker. If the patient transfers directly to a wheelchair once standing, Medicare may not cover the device.

Steps to Obtain a Covered Lift Chair

Once the medical necessity criteria are met, obtaining a lift chair that may be covered by Medicare involves several procedural steps. The first step requires securing a detailed written order, or prescription, from a physician. This order must explicitly state the medical necessity for the lift chair.

The physician will also need to complete specific documentation, such as the Certificate of Medical Necessity for Seat Lift Mechanisms form (CMS-849). This form provides the necessary medical justification for Medicare reimbursement. It is essential to obtain the lift chair from a Durable Medical Equipment supplier who is enrolled in Medicare and accepts assignment, meaning they agree to accept Medicare’s approved amount as full payment.

The supplier typically handles the submission of the claim to Medicare on behalf of the beneficiary. In some instances, certain DME items, including specific lift chairs, may require prior authorization from Medicare before coverage is approved. The Medicare-approved supplier usually manages this authorization process as well.

Understanding Your Costs

Even when a lift chair is covered by Medicare, beneficiaries are responsible for certain financial obligations. Under Medicare Part B, after the annual deductible is met, Medicare typically pays 80% of the Medicare-approved amount for the lifting mechanism. For 2025, the Part B deductible is $257.

The beneficiary is responsible for the remaining 20% coinsurance of the Medicare-approved amount, in addition to any unmet portion of their annual deductible. The cost of the chair’s other components, such as the frame and upholstery, is not covered by Medicare and remains the full responsibility of the beneficiary.

DME items, including lift chairs, may be rented or purchased, and Medicare often determines which option applies. For many rental items, including lift chairs, ownership can transfer to the beneficiary after approximately 13 consecutive months of rental payments. It is advisable to consult directly with the DME supplier and Medicare to understand specific cost estimates tailored to individual circumstances.