Does Medicare Help Pay for a Lift Chair?
Navigate Medicare's rules for lift chair coverage. Understand eligibility, costs, and the steps to seek financial support for the lift mechanism.
A lift chair includes a motorized mechanism designed to assist individuals in safely transitioning from a sitting to a standing position. Medicare may help cover only a portion of the cost, specifically for the power seat lift mechanism itself, not the entire chair. This coverage is available under very specific medical conditions.
Medicare’s Coverage Conditions for Lift Chairs
Medicare classifies the power seat lift mechanism of a lift chair as Durable Medical Equipment (DME). A physician must determine and document that the lift mechanism is medically necessary. This requires a doctor’s prescription or order, often involving the completion of a “Certificate of Medical Necessity for Seat Lift Mechanisms Form” (CMS-849).
Medical conditions warranting coverage include severe arthritis of the hip or knee, or a severe neuromuscular disease. The patient must be unable to stand from a chair without assistance. Once standing, the individual must be able to walk independently or with a walker or cane. Medicare does not cover lift chairs if the patient is confined to a bed or another chair, or for reasons of comfort or convenience.
Understanding Your Financial Responsibility
If the power seat lift mechanism is deemed medically necessary, Medicare Part B covers 80% of the Medicare-approved amount. This applies after the annual Part B deductible is met. For 2025, the annual deductible for Medicare Part B beneficiaries is $257.
The patient is responsible for the remaining 20% coinsurance and any unmet Part B deductible. It is important to obtain the lift mechanism from a supplier who is enrolled in Medicare and “accepts assignment.” A supplier who accepts assignment agrees to accept Medicare’s approved amount as full payment, helping to prevent balance billing. If a supplier does not accept assignment, the patient may have to pay the full amount upfront and then seek partial reimbursement from Medicare, or face higher out-of-pocket costs.
Steps to Obtain a Lift Chair Through Medicare
The first step to obtaining a lift chair with potential Medicare coverage involves consulting with your physician. Your doctor will assess your medical condition during an in-person evaluation to determine if a lift mechanism is medically necessary for your specific circumstances. If it is deemed necessary, your doctor will provide a written prescription or order for the power seat lift mechanism.
Following the doctor’s assessment, you will need to find a Durable Medical Equipment (DME) supplier that is enrolled in Medicare. It is advisable to confirm that the supplier accepts Medicare assignment, which can help manage your out-of-pocket expenses. This choice ensures the supplier will bill Medicare directly for the approved portion of the lift mechanism.
Before finalizing the purchase, confirm with the supplier that they will submit the claim to Medicare for the power seat lift mechanism. You will then be billed for your portion, which includes the 20% coinsurance and any remaining Part B deductible. Keeping records of all documentation, including the prescription and supplier invoices, can help streamline the process.