Hospital Beds

 
Insurance Information on Hospital Beds
 
Medicare covers a hospital bed when the patient cannot use a normal bed because he/she needs to:
 

• change body positions in ways not possible with a normal bed, or
• be in body positions not possible with a normal bed in order to relieve pain, or
• have the head of the bed higher than 30 degrees most of the time due to illnesses such as congestive heart failure, chronic pulmonary disease, and others, or
• use traction equipment that must be attached to a hospital bed.

 
A fixed height hospital bed is covered if one or more of the following criteria are met:
 

• The patient has a medical condition that requires positioning of the body in ways not feasible with an ordinary bed. Elevation of the head/upper body less than 30 degrees does not usually require the use of a hospital bed, or
• The patient requires positioning of the body in ways not feasible with an ordinary bed in order to alleviate pain, or
• The patient requires the head of the bed to be elevated more than 30 degrees most of the time due to congestive heart failure, chronic pulmonary disease, or problems with aspiration. Pillows or wedges must have been considered and ruled out, or
• The patient requires traction equipment, which can only be attached to a hospital bed.

 
A variable height hospital bed is covered if the patient meets one of the criteria for a fixed height hospital bed and requires a bed height different than a fixed height hospital bed to permit transfers to chair, wheelchair or standing position.
 
A semi-electric hospital bed is covered if the patient meets one of the criteria for a fixed height bed and requires frequent changes in body position and/or has an immediate need for a change in body position.
 
A heavy-duty extra-wide hospital bed is covered if the patient meets one of the criteria for a fixed height hospital bed and the patient weighs more than 350 pounds, but does not exceed 600 pounds.
 
An extra heavy-duty hospital bed is covered if the patient meets one of the criteria for a hospital bed and the patient's weight exceeds 600 pounds.
 
A total electric hospital bed is not covered; Medicare considers it a convenience item. However, if you prefer the total electric, you can pay the differences between the bed for which you qualify and this one using the Advanced Beneficiary Notice.
 
An order (prescription) must be on file with the supplier. It must be signed and dated by the treating doctor. Hospital Beds are in the Capped Rental category of DME; that means you may choose to rent or purchase a hospital bed.
 
Most insurors follow similar coverage guidelines as Medicare.
 
If you have specific insurance questions, click here to contact Home MediService.