Medicare Part B (Medical Insurance) will cover patient lifts / lift chairs as durable medical equipment (DME) that a doctor prescribes for use in a Medicare enrollee’s home. In order to be eligible for this coverage, the supplier of the lift chair must accept Medicare assignment.
There are some out-of-pocket costs to the Medicare beneficiary for this service. For example, the patient must pay 20 percent of the Medicare-approved amount. In addition, the Medicare Part B annual deductible will also apply. In 2015, the amount of the Part B deductible is $147.
In order to accept Medicare assignment, doctors and medical equipment suppliers are required to meet strict standards. If these entities are not enrolled in Medicare, then Medicare will not pay the claims that are submitted by them.
It is important that you inquire of a medical equipment supplier whether or not they accept Medicare assignment prior to obtaining any equipment from them. This is because if they do not accept Medicare assignment, they may charge you an unlimited amount for the equipment.
What is the Competitive Bidding Program?
If you reside in or visit certain areas of the United States, you could be affected by the Medicare Competitive Bidding Program when it comes to obtaining a lift chair, or any other durable medical equipment. Medicare is phasing in this program in some areas of the country. This program changes the amount that Medicare pays suppliers for certain durable medical equipment (DME), and it also changes who may supply these items.
Under this program, suppliers submit bids in order to set the amount that they pay for the equipment and supplies. The qualified, accredited suppliers that have winning bids are then chosen as Medicare contract suppliers.
The Competitive Bidding Program is meant to help Medicare enrollees and Medicare save money. It also is intended to provide Medicare enrollees access to quality medical equipment, supplies, and services from trustworthy suppliers. In addition, the program may also help in limiting fraud and abuse within the Medicare program.
If you are enrolled in Medicare Part A and Part B (Original Medicare) and you get competitively bid equipment and supplies in competitive bidding areas, then Medicare may only help to pay for these equipment and supplies if they are provided by contract suppliers.
A contract supplier is not allowed to charge you more than the 20 percent co-insurance amount and any unmet annual deductible for any equipment or supplies included in the Competitive Bidding Program.
It is important to note that, depending on the type of medical equipment, it may be required that you either rent or purchase it – or, you may be able to decide whether you wish to rent it or purchase it outright.
In order to determine how much a specific item will cost, talk to your doctor or other health care provider. This is because the specific amount that you owe can depend on a variety of different factors, such as other insurance that you may have, how much the supplier charges, and / or where you obtain your item.