Taxation and Regulatory Compliance

Is a Lift Chair Covered by Medicare?

Demystify Medicare's approach to lift chair coverage. Learn about eligibility, costs, and the practical steps to secure support for mobility.

Lift chairs offer valuable assistance to individuals facing mobility challenges, providing support when moving from a seated to a standing position. Medicare, the federal health insurance program, covers certain medically necessary medical equipment for eligible beneficiaries. This coverage helps individuals manage health conditions in their home.

Medicare Part B Coverage for Lift Chairs

Medicare Part B covers medical services and supplies, including Durable Medical Equipment (DME). The lifting mechanism within a lift chair can be considered DME. Medicare covers only the motorized lifting mechanism, not the furniture portion, such as the chair frame, upholstery, or luxury features like heat or massage.

Durable Medical Equipment, as defined by Medicare, must meet several criteria. It must be durable, meaning it can withstand repeated use. It must be used for a medical reason and not typically useful to someone without an illness or injury. DME must also be appropriate for home use and have an expected lifespan of at least three years.

Meeting Eligibility Requirements

For Medicare to cover a lift chair’s lifting mechanism, specific medical necessity criteria must be met. A physician must prescribe the lift chair, confirming its medical necessity. This prescription must justify that the device will help improve a condition or slow its progression.

Individuals qualify if they have severe arthritis of the hip or knee, or a severe neuromuscular disease. The person must be unable to stand up from a regular chair without assistance. Once standing, the individual must still be able to walk, even if they use a cane or walker for support. The lift chair must be obtained from a Medicare-enrolled supplier who accepts assignment.

Understanding Your Financial Responsibility

When Medicare covers a lift chair’s lifting mechanism, beneficiaries have certain financial responsibilities. The annual Medicare Part B deductible, $257 for 2025, must be met. After the deductible is satisfied, Medicare pays 80% of the Medicare-approved amount for the lifting mechanism.

The beneficiary is responsible for the remaining 20% coinsurance. It is beneficial to choose a supplier who “accepts assignment,” meaning they accept the Medicare-approved amount as full payment. Suppliers who accept assignment cannot charge more than the Medicare deductible and coinsurance, which helps manage out-of-pocket costs.

How to Get Medicare Coverage for a Lift Chair

The process of obtaining Medicare coverage for a lift chair begins with consulting your treating physician. Discuss your mobility needs and how a lift chair might assist you. Your doctor will evaluate your condition and provide the necessary prescription and medical justification. This often involves completing Medicare form CMS-849, the Certificate of Medical Necessity for Seat Lift Mechanisms.

Find a Durable Medical Equipment (DME) supplier that is enrolled in Medicare and accepts assignment. You can search online or contact Medicare directly for a list of approved suppliers in your area. Once you select a supplier, they will handle the billing process directly with Medicare, submitting all required documentation. After the claim is processed and the lift chair is delivered, review your Medicare Summary Notice (MSN) or Explanation of Benefits (EOB). This document will detail what Medicare paid and your remaining financial responsibility.

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