When a doctor deems it medically necessary, Medicare will cover hospital beds to use at home. Generally, Part B will cover 80% of the cost. Medigap and Medicare Advantage may pay more.
There are times when a doctor may feel it is medically necessary for a person to use a hospital bed at home. If this is the case, then Medicare will help cover the cost of this durable medical equipment (DME).
Glossary of Medicare terms
We may use a few terms in this article that can be helpful to understand when selecting the best insurance plan:
- Out-of-pocket costs: An out-of-pocket cost is the amount a person must pay for medical care when Medicare does not pay the total cost or offer coverage. These costs can include deductibles, coinsurance, copayments, and premiums.
- Deductible: This is an annual amount a person must spend out of pocket within a certain period before an insurer starts to fund their treatments.
- Coinsurance: This is the percentage of treatment costs that a person must self-fund. For Medicare Part B, this is 20%.
- Copayment: This is a fixed dollar amount a person with insurance pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.
Medicare provides coverage for certain types of durable medical equipment (DME), such as hospital beds, when a doctor prescribes its use.
Items are considered DME when they meet the following criteria:
- it is durable, meaning it can withstand repeated use
- it is used for medical reasons
- it is used in the home
- it is typically used for someone who is sick or injured
- it is expected to last at least 3 years
Typically people will rent DME, but sometimes they can buy the equipment. Individuals may be able to choose whether they would like to rent or buy a hospital bed.
Learn more about Medicare and medical devices.
Under Original Medicare, Part B will cover hospital beds for use at home.
It is important that both the prescribing doctor and the supplier of the hospital bed are enrolled in Medicare. A person should always check that the supplier is part of Medicare before getting any kind of DME from them.
In order for Medicare Part B to cover a hospital bed, the prescribing doctor must not only provide a prescription but other detailed paperwork as well. They must also provide detailed information on the individual’s medical condition and establish the need for a hospital bed. The order must include:
- documentation that shows the individual needs the positioning of the bed to:
- relieve pain
- promote body alignment
- prevent respiratory infections
- documentation that shows the individual requires special attachments that cannot be fitted to a traditional bed
Medigap, or supplement insurance, may also help pay for the costs of a hospital bed.
Medicare Advantage (Part C) plans must provide the same coverage as Original Medicare. This means they will generally cover the use of hospital beds at home. A person can speak with their provider for more information.
Learn more about Medicare Part B.
Medicare covers certain types of hospital beds. These include:
| Bed type | Description |
|---|---|
| Fixed height bed | •manual head and leg adjustments •no height adjustment |
| Variable height bed | •manual height adjustment •manual head and leg adjustment |
| Semi-electric bed | •manual height adjustment •electric head and leg elevation adjustments |
| Total electric bed | •electric height adjustment •electric head and leg adjustments |
| Extra-wide bariatric bed 1 | supports individuals between 350 lb and 600 lb |
| Extra-wide bariatric bed 2 | supports individuals above 600 lb |
Accessories
Medicare will also cover certain accessories for hospital beds that are medically necessary. These may include:
- bed rails
- trapeze bars above a hospital bed to help a person sit up
Items, such as an over-the-bed table, are not covered as they are considered a convenience, not a necessity.
Read about hospital bed mattresses and toppers.
After an individual has met the Medicare Part B deductible, Medicare will generally cover 80% of the cost of a hospital bed.
The Part B deductible in 2024 is $240. This means that once a person has spent more than that amount, they are only responsible for 20% of services, care, and equipment.
A person with Original Medicare can contact Medicare either through live chat on the website or by calling 800-633-4227 to discuss coverage and costs.
Individuals with Medicare Advantage can either contact Medicare or their insurance provider to discuss their needs.
Medicare resources
For more resources to help guide you through the complex world of medical insurance, visit our Medicare hub.
Medicare Part B and Medicare Advantage plans will typically cover the use of a hospital bed at home if a doctor deems it medically necessary.
Generally, a person will be responsible for 20% of the cost if they have met the annual deductible.
Individuals can contact Medicare to discuss coverage and cost.