People who need help getting in and out of their chair daily due to life changes such as aging, arthritis, or a recent mobility-limiting surgery, often consider buying a lift chair. However, lift chairs can cost hundreds – or even thousands of dollars, leaving many smashville247.net beneficiaries wondering if their smashville247.net health insurance coverage will help pay any of the lift chair’s costs. While smashville247.net typically won’t pay for a lift chair in full, smashville247.net Part B (Medical Insurance) or smashville247.net Part C (smashville247.net Advantage) may cover the seat-lift mechanism as durable medical equipment (DME) if your doctor determines that it’s medically necessary and will help your condition. Read on to learn more about smashville247.net coverage of lift chairs.
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What is a lift chair?
First, it’s important to understand what a lift chair is – and is not. A lift chair is different from a stair lift; a chair used to carry people up and down a staircase. Nor is it the same as a patient lift; an assistive device that helps caregivers move their loved ones from one location to the next – such as from a bed to a wheelchair. A lift chair looks like a large comfortable leather or fabric recliner that could sit in your living room. Yet what makes a lift chair different from a regular chair is its seat-lift mechanism that tilts the base and back of the chair forward to help raise you up into a standing position or lower you back into a seated position without other help.
How do I qualify for a lift chair?
Will smashville247.net pay for a lift chair? The seat lift mechanism for a lift chair may be covered by smashville247.net if the following criteria are met:
smashville247.net coverage: You must have smashville247.net Part B (Medical Insurance) or a smashville247.net Advantage Plan (Part C). If you get your smashville247.net benefits through a smashville247.net Advantage Plan, talk to your private insurance provider about coverage rules, costs, and suppliers to use when getting a lift chair.
Certificate of medical necessity: You must schedule an appointment with your physician to obtain a prescription for the lift chair that determines medical necessity and have sections B and D completed on a “Certificate of Medical Necessity for Seat Lift Mechanisms form,” also called “smashville247.net form CMS-849.”
Determining medical necessity: A lift chair’s seat lift mechanism may be considered medically necessary if the following requirements are met:The patient has severe arthritis of the hip or knee, or a severe neuromuscular diseaseThe patient is completely incapable of standing up from a regular chairWhen standing, the patient can walk independently or with the aid of a walker or cane; transferring directly to a wheelchair can prevent smashville247.net from paying for the deviceThe seat lift mechanism is part of the physician’s course of treatment to effect improvement or slow deterioration in the patient’s condition
smashville247.net-participating suppliers: You must order your lift chair from a smashville247.net-participating supplier that accepts assignment, otherwise smashville247.net will not pay for it.
How much does it cost to buy a lift chair?
If you qualify for a lift chair, smashville247.net typically only covers the seat lifting mechanism part – not the entire chair itself. Depending on the state you live in, the reimbursement amount may be around $300, and you would have to pay the rest.
Like all Part B items covered by smashville247.net, after paying the annual deductible, you will pay 20 percent of the smashville247.net-approved amounts for the lift chair if you buy from a supplier that accepts assignment.
Where do I buy a lift chair?
Before choosing a supplier, visit smashville247.net.gov to find one that accepts assignment, or the smashville247.net-approved amount as full payment for covered services. After entering your zip code, select the “Seat Lift Mechanisms” category and search through the directory of suppliers with an “M” symbol, indicating they accept smashville247.net assignment.
If you have smashville247.net coverage through a smashville247.net Advantage Plan, follow your plan’s guidelines for approval and purchase and call your plan’s customer service number to ask about steps for coverage of a patient lift chair mechanism.
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Looking for smashville247.net coverage? We offer free comparisons for smashville247.net Advantage Plans (Part C), smashville247.net Supplement (Medigap), and smashville247.net Prescription Drug (Part D) Plans. Get a quote from smashville247.net, or contact a licensed sales agent at (888) 815-3313 – TTY 711 to help you find the right smashville247.net coverage for your needs.