Is a Hospital Bed Covered by Medicare?

A hospital bed for home use is a specialized piece of medical equipment designed to provide enhanced comfort, safety, and support for individuals with specific health needs. These beds typically feature adjustable head and foot sections, variable height capabilities, and side rails, distinguishing them from standard household beds. Individuals might require a hospital bed at home for various reasons, including managing chronic illnesses, recovering from surgery, or addressing mobility limitations. This equipment helps individuals receive care at home.

Medicare Coverage Requirements

Hospital beds are classified by Medicare as Durable Medical Equipment (DME), which is medical equipment that can withstand repeated use. To qualify as DME, an item must primarily serve a medical purpose, not generally be useful to someone without an illness or injury, be suitable for home use, and have an expected lifespan of at least three years. Medicare Part B provides coverage for hospital beds when a physician determines they are medically necessary for use in a beneficiary’s home.

Medical necessity for a hospital bed is established when a patient’s condition requires specific body positioning not feasible with an ordinary bed. This can include needs such as alleviating pain, promoting proper body alignment, preventing contractures, or avoiding respiratory complications. A hospital bed may also be deemed medically necessary if the patient’s condition necessitates special attachments, like traction equipment, that cannot be secured to a standard bed. Additionally, a hospital bed may be deemed medically necessary if the patient requires the head of the bed to be elevated more than 30 degrees for most of the time due to conditions like congestive heart failure, chronic pulmonary disease, or issues with aspiration.

A physician’s order, or prescription, is required to document the medical necessity for the hospital bed. The order must detail the patient’s diagnosis, the specific medical reason for needing the bed, and how it will benefit their condition. For positioning needs, the prescription should describe the medical condition and symptoms. If special attachments are needed, the order must specify them. A face-to-face encounter with the physician is often a prerequisite for this documentation.

Medicare typically covers basic manual and semi-electric hospital beds. Manual beds require hand cranks for adjustments, while semi-electric beds allow electronic adjustment of the head and foot sections, with manual height adjustment. Extra-wide or bariatric beds may also be covered if the patient’s weight exceeds 350 pounds and meets specific criteria for a fixed height bed.

Fully electric beds, which include electric height adjustment, are not covered as they are considered a convenience item, though beneficiaries can pay the cost difference if they prefer this type. Certain accessories, such as trapeze bars, specific pressure-relieving mattresses, and side rails, may also be covered if they are medically necessary. To ensure coverage, both the prescribing physician and the Durable Medical Equipment supplier must be enrolled in Medicare.

Understanding Your Costs

Medicare Part B provides financial assistance for medically necessary hospital beds. After meeting the annual Part B deductible, which is $257 in 2025, beneficiaries are typically responsible for 20% of the Medicare-approved amount for the hospital bed. Medicare covers the remaining 80% of the approved cost.

Select a supplier that “accepts assignment.” This means the supplier agrees to accept Medicare’s approved amount as full payment for the equipment. When a supplier accepts assignment, your out-of-pocket expenses are limited to the deductible and 20% coinsurance. If a supplier does not accept assignment, they are permitted to charge more than Medicare’s approved amount, and you would be responsible for paying the difference, in addition to the deductible and coinsurance.

For individuals seeking to further reduce their out-of-pocket costs, supplemental insurance options may be available. Medigap policies, also known as Medicare Supplement Insurance, can help pay for some of the costs that Original Medicare does not cover, such as the Part B coinsurance. Medicare Advantage Plans (Part C), offered by private companies approved by Medicare, are required to provide at least the same coverage as Original Medicare. Many of these plans offer additional benefits and may have different cost-sharing structures that could potentially lower out-of-pocket expenses for a hospital bed.

Steps to Obtain a Hospital Bed

The process begins with securing a physician’s order that clearly states the medical necessity, including the diagnosis and how the bed’s features address the patient’s condition. This documentation is foundational, as it validates the need for the specialized equipment under Medicare guidelines. Once the physician’s order is in hand, the next step involves locating a Medicare-approved Durable Medical Equipment (DME) supplier. Beneficiaries can search for approved suppliers using Medicare.gov or by consulting their physician. Confirm the chosen supplier participates in Medicare and accepts assignment to maximize coverage and minimize unexpected expenses.

After selecting a supplier, they will typically verify coverage with Medicare based on the physician’s order and then arrange for the delivery and setup of the hospital bed in the patient’s home. Some suppliers or specific equipment may require prior authorization from Medicare before delivery can proceed, which can extend the timeline for acquisition. The supplier will often handle the submission of claims to Medicare.

Medicare offers options for renting or purchasing a hospital bed, depending on the patient’s anticipated duration of need. If renting, Medicare covers its portion of monthly payments. Ownership typically transfers to the beneficiary if a bed is rented for 13 continuous months. Renting is often more cost-effective for short-term needs, while purchasing may be preferred for long-term use.