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Will Medicare Cover My Lift Chair?

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Will Medicare Pay for My Lift Chair?

Will Medicare Cover my Lift Chair?

This is often the first question that is asked when shopping for a lift chair. Medicare will no longer reimburse the entire cost of the lift chair but it will pay for the cost of the lifting mechanism. Under Medicare the lift mechanism is considered durable medical equipment (DME) which is covered if your doctor prescribes it for use in your home. The total amount of reimbursement can vary from state to state, but it is usually around $300.

Most likely you will have to pay for the lift chair up front and then fill out a claim to Medicare for reimbursement. Reimbursement may be made for a purchase of a medically necessary lift chair but the patient must suffer from severe arthritis of the hip or knee, muscular dystrophy or from other neuromuscular diseases. Medicare policy states that the lift chair must be included in the physician's course of treatment, that it is likely to effect improvement, or that it may arrest or retard deterioration in the patient's condition.

Additionally, the coverage of the lift mechanism in lift chairs is limited to those types which operate smoothly, can be controlled by the patient, and effectively assist a patient in standing up and sitting down without other assistance. There is a type of lift that is operated by a spring release mechanism that is not covered by Medicare because of its sudden, catapult-like motion.

How Do I File For Medicare Exactly?

It's actually a fairly simple process. You will need 3 things to file.

* A CMN (Certificate of Medical Necessity)
* A bill of sale
* A doctor's prescription for a lift chair and your doctor's signature on the CMN.

Most distributors will provide the CMN straight from their website or through the mail and will also provide you with the bill of sale after purchase. There are 5 questions your doctor will need to answer on the CMN.

1. Does patient have severe arthritis of the hip or knees?

2. Does patient have a severe neuromuscular disease?

3. Is the patient completely incapable of standing up from a regular armchair or any chair in his/her home?

4. Once standing, does the patient have the ability to ambulate (walk or move about)?

5. Have all appropriate therapeutic modalities to enable the patient to transfer from a chair to a standing position (e.g., medication, physical therapy) been tried and failed? If YES, this is documented in the patient's medical records.

Once your doctor has completed and signed the CMN, you must then mail it with a copy of your prescription for the lift chair to your Medicare regional claims office. If you are approved, a reimbursement check will be mailed back to you.