Does Medicare Cover the Cost of Chair Lifts?
Navigate Medicare's rules for equipment like chair lifts and find practical ways to fund essential home modifications.
Medicare is a federal health insurance program covering millions of Americans, primarily those aged 65 or older and certain younger individuals with disabilities. The program is divided into several parts, each covering different services. Understanding Medicare’s coverage for medical devices used in the home is important for beneficiaries.
Understanding Medicare’s Coverage for Durable Medical Equipment
Medicare Part B covers durable medical equipment (DME) if it is medically necessary and prescribed by a doctor for home use. To qualify as DME, equipment must withstand repeated use, be used for a medical reason, and primarily benefit someone sick or injured. It must also be suitable for home use and expected to last at least three years. Common examples of DME covered by Medicare Part B include wheelchairs, walkers, hospital beds, oxygen equipment, and patient lifts.
To receive DME coverage, a Medicare-enrolled doctor or healthcare provider must prescribe the equipment, stating its medical necessity for home use. Beneficiaries are responsible for 20% of the Medicare-approved amount after meeting their Part B deductible, with Medicare covering 80%. DME must be obtained from a Medicare-enrolled supplier who accepts assignment, agreeing to the Medicare-approved amount.
Medicare’s Stance on Chair Lift Coverage
Medicare does not cover the cost of chair lifts, also known as stair lifts. The reason for this exclusion is that Medicare classifies chair lifts as home modifications or accessibility aids, not durable medical equipment. DME is defined by Medicare as items directly used for medical treatment or to improve the function of a diseased or injured body part. Chair lifts, while beneficial for mobility, are considered permanent alterations to the home’s structure.
Medicare’s focus for DME is on items that serve a medical purpose and are not considered improvements to a living space. Even if a doctor suggests a chair lift for medical reasons, Original Medicare (Parts A and B) will not cover it because it falls outside the definition of DME. Some Medicare Advantage (Part C) plans may offer additional benefits that could include coverage for chair lifts, but this is uncommon and varies by plan.
Finding Other Ways to Fund a Chair Lift
Since Medicare does not cover chair lifts, exploring alternative funding sources is important. State Medicaid programs may offer assistance, as their rules for home modifications or assistive technology vary. Many state Medicaid programs include Home and Community-Based Services (HCBS) waivers that may cover the cost of home modifications, including chair lifts, to allow individuals to remain in their homes. Eligibility for these programs depends on medical and financial criteria, and waiting lists may apply.
Veterans can find support through the Department of Veterans Affairs (VA). If a chair lift is needed due to a service-related injury, the VA may cover the cost through grants like the Home Improvements and Structural Alterations (HISA) grant or the Specially Adapted Housing (SAH) grant. For non-service-related needs, programs such as the VA Aid and Attendance benefit or the Veterans Directed Home and Community Based Services (VD-HCBS) may provide financial assistance. Non-profit organizations and state-specific assistive technology programs also offer grants, loans, or financial aid for home modifications. Private health insurance plans may offer limited coverage for durable medical equipment or home modifications, but this varies by policy, requiring direct communication with the insurer to understand benefits.