Does Medicare Pay for a Hospital Bed?

Medicare offers support for various medical needs, such as home medical equipment. Many wonder if Medicare covers hospital beds. Coverage depends on how Medicare classifies the equipment and the conditions required.

Understanding Medicare Coverage for Hospital Beds

Medicare provides coverage for certain medical equipment, classifying hospital beds under Durable Medical Equipment (DME). For an item to qualify as DME, Medicare defines it as equipment that can withstand repeated use, serves a medical purpose, is used in the home, and is expected to last for at least three years. Hospital beds meet these criteria.

Coverage for hospital beds is provided under Medicare Part B, which covers medical services and supplies. For a hospital bed to be covered, it must be deemed medically necessary by a doctor. A physician must prescribe the bed for use in the home, documenting the medical necessity.

Medical necessity arises from conditions requiring specific positioning for pain relief, improved breathing, or proper body alignment. Examples include severe arthritis, bone fractures, or respiratory conditions that cannot be adequately managed with a standard bed. The doctor’s order must explain why a hospital bed benefits the individual’s condition.

Medicare covers basic manual or semi-electric hospital beds, including features like adjustable height and head/foot sections. Accessories such as side rails and trapeze bars are also covered if they are medically necessary. However, advanced features like fully motorized functions, massage, or heat therapy are not covered, as Medicare considers these comfort or convenience items.

Steps to Obtain a Covered Hospital Bed

Obtaining a Medicare-covered hospital bed begins with a physician’s assessment and prescription. A doctor must evaluate the individual’s medical condition and provide a written order for a hospital bed. This documentation should outline the diagnosis, the specific features required, and how the bed will address the medical necessity.

The next step involves selecting a Durable Medical Equipment (DME) supplier that is enrolled in Medicare. It is important to confirm that the supplier participates in Medicare and agrees to “accept assignment.” Accepting assignment means the supplier agrees to accept the Medicare-approved amount as full payment for the equipment, which helps limit the individual’s out-of-pocket costs.

Individuals can locate Medicare-approved DME suppliers through the Medicare.gov website’s Supplier Directory or by calling 1-800-MEDICARE. This ensures that the supplier meets Medicare’s standards and that the claim will be processed correctly. Using a non-approved supplier could result in the individual being responsible for the entire cost of the bed.

Once the prescription is obtained and a Medicare-approved supplier is chosen, the supplier handles the processing of the request with Medicare. This includes submitting the necessary documentation and coordinating the delivery and setup of the hospital bed in the individual’s home. The supplier is also responsible for providing instructions on how to use the equipment properly.

Financial Responsibilities and Options

When Medicare covers a hospital bed, beneficiaries have specific financial responsibilities. Individuals with Original Medicare must first satisfy their Medicare Part B annual deductible. For 2025, this deductible is $257.

After the deductible is met, Medicare Part B pays 80% of the Medicare-approved amount for the hospital bed. The individual is responsible for the remaining 20% coinsurance. This 20% share applies whether the equipment is rented or purchased.

Medicare offers options for both renting and purchasing hospital beds, depending on the specific item and the medical necessity. Rental is a common arrangement, especially for temporary needs. If a bed is rented, Medicare will cover its portion of the monthly payments.

For certain DME, including hospital beds, if rented for a continuous period, ownership may transfer to the beneficiary after 13 months of rental payments. This arrangement ensures that individuals who require a hospital bed for an extended duration eventually own the equipment. The specific terms of rental versus purchase are determined by Medicare guidelines and the supplier’s policies.