Does Medicare Pay for a Hospital Bed at Home?

It is a common inquiry for individuals and their families to determine whether Medicare provides coverage for a hospital bed for use at home. Many people require specialized bedding due to various health conditions, and understanding the financial aspects of obtaining such equipment can be complex. This article explains how Medicare covers hospital beds, the specific requirements for coverage, the process to acquire one, and the associated financial responsibilities.

Medicare Coverage for Hospital Beds

Hospital beds are generally categorized as Durable Medical Equipment (DME) by Medicare. Medicare Part B covers medically necessary DME, including hospital beds, when prescribed by a doctor for use in a beneficiary’s home.

Durable Medical Equipment (DME) refers to items that can withstand repeated use, serve a medical purpose, are used in the home, and are expected to last at least three years. For a hospital bed to be covered, it must be ordered by a Medicare-participating doctor, and the equipment provider must also be Medicare-approved.

Meeting Medicare’s Specific Requirements

To qualify for Medicare coverage of a hospital bed, beneficiaries must demonstrate medical necessity. A physician’s order is required, clearly specifying the medical reason for the bed, including the diagnosis. This documentation ensures the bed is considered reasonable and necessary for the diagnosis or treatment of an illness or injury.

The physician’s order should describe the medical condition and detail the severity and frequency of symptoms necessitating a hospital bed for positioning. This includes conditions requiring specific body positioning to alleviate pain or prevent complications, or the need to elevate the head of the bed more than 30 degrees due to conditions like congestive heart failure or chronic pulmonary disease. A hospital bed may also be covered if the patient requires traction equipment that can only be attached to such a bed. Medicare may also cover specific features like variable height for patients with severe arthritis or spinal cord injuries, or semi-electric beds for those needing frequent position changes.

The Process for Obtaining a Covered Hospital Bed

After medical necessity is established and a physician’s order obtained, the next step is securing the equipment. It is essential to find a Durable Medical Equipment (DME) supplier that is approved by Medicare. Medicare maintains a supplier directory on its official website, or individuals can call 1-800-MEDICARE for assistance.

The chosen Medicare-approved supplier will work with the prescribing doctor to gather all necessary documentation, including the physician’s order and supporting medical records. This ensures the claim submitted to Medicare is complete and accurate. Medicare determines whether the bed is rented or purchased, which can depend on the type of bed and supplier policies. In many cases, Medicare may initially cover the bed through rental payments, with ownership potentially transferring after 13 months of continuous rental.

Your Financial Responsibility

When Medicare covers a hospital bed, beneficiaries are typically responsible for a portion of the cost. Under Medicare Part B, after the annual deductible is met, Medicare pays 80% of the Medicare-approved amount for Durable Medical Equipment. The beneficiary is responsible for the remaining 20% coinsurance. For 2025, the annual Part B deductible is $257.

Financial responsibility is also influenced by whether the DME supplier accepts “assignment.” Accepting assignment means the supplier agrees to accept the Medicare-approved amount as full payment, preventing them from charging more than the deductible and coinsurance. If a supplier does not accept assignment, they may charge up to a “limiting charge,” typically 15% above the Medicare-approved amount. Supplemental insurance plans, such as Medigap or Medicare Advantage plans, may help cover some or all of these out-of-pocket costs.