Medicaid and Other Financial Assistance for Hospital Beds at Home
- Learn about Medicaid and other financial assistance for hospital beds at home, including what the definition of durable medical equipment is when it's covered by Medicaid.
Medicaid is a Federal program that provides medical insurance to low-income older adults. Medicaid coverage specifics can vary by state, but in general terms, Medicaid will pay for hospital beds for at-home use if they fall under the durable medical equipment (DME) category. However, the equipment must these meet specific criteria:
- Equipment can withstand repetitive use.
- Equipment must be used for medical purposes.
- Equipment can be used in in-home settings.
Specific Medicaid requirements for hospital beds for in-home include the following:
- Hospital beds must be cleared to market by the FDA.
- Beds must include mattresses, ends with casters, IV sockets and side rails.
- Beds must be capable of supporting overhead accessories such as trapeze bars and frames.
Hospital beds for in-home use meet Medicaid's DME requirement. It's important to note that there are hundreds of Medicaid programs throughout the United States, so specific criteria may differ slightly from state to state.
Medicaid Assistance for Hospital Beds at Residential Homes vs. Nursing Homes
Nursing Home Residents
For nursing home residents who live in Medicaid-approved skilled nursing facilities, the overall approval process of obtaining DME through Medicaid takes place at the administrative level. The individual in need of the hospital bed is typically unaware of the acquisition and approval procedures. Once approved, the recipient is simply provided with the DME/hospital bed.
DME Hospital Beds for Residential Use at Home
Medicaid services obtained outside of skilled nursing home facilities are referred to as Home and Community-Based Services or HCBS. These services allow for certain types of DME to be covered through Medicaid. To be a part of the HCBS program, recipients' specific needs are assessed on an individual basis. Following the assessment, care recipients are provided with a set amount of funds that can be used for the purchase of DME and medical supplies.
When requesting a hospital bed for use at home, recipients must first acquire medical justification letters from their physicians that detail the specific equipment needed — in this case, a hospital bed for in-home use. The Medicaid-approved supplier must also fill out a prior approval application and turn it into the state Medicaid office.
The application is reviewed, and if approved, Medicaid informs the care recipient and supplier of its decision. The hospital bed or other DME is then sent directly to the care recipient via the supplier, which then bills Medicaid for the equipment.
Medicaid's Money Follows the Person Program for Hospital Beds at Home
Certain state Medicaid programs offer MFP or Money Follows the Person Programs. These programs are available in 44 states, excluding Arkansas, Arizona, Florida, New Mexico, Utah and Wyoming. MFP programs provide assistance to individuals who are transitioning out of Medicaid-approved nursing homes and back into home environments. The programs pay for DME including hospital beds for home use to aid recipients in the transition back to their own homes or the homes of loved ones.
State Medicaid Programs That Assist With DME
While specific requirements and regulations can vary from state to state, the following list of programs all provide assistance with DME:
- Alabama SAIL Waiver
- Alabama Community Transition Waiver
- Alaskans Living Independently
- Alaska Adults With Physical and Developmental Disabilities Waiver
- Arizona LTC Services
- Arizona Self Directed Attendant Care
- Arkansas Independent Choices Program
- California Medi-Cal Independent Senior Services Program Waiver
- California Medi-Cal Home and Community-Based Alternatives
- Connecticut Personal Care Assistance
- Delaware Diamond State Health Plan Plus
- Florida Statewide Managed Long Term Care
- Idaho HCBS Aged and Disabled Waiver
- HealthChoice Illinois
- Illinois Medicaid-Medicare Alignment Initiative
- Indiana Aged and Disabled Waiver
- Indiana Structured Family Caregiver/Caregiving Homes
- Iowa HCBS Elderly Waiver
- Kansas HCBS Frail and Elderly Waiver
- Kentucky Supports for Community Living Waiver
- Louisiana Community Choices Waiver
- Maine Older Adults and Adults with Disabilities
- Maine Consumer Directed Attendant Services
- Maryland Community Options Waiver for Older Adults
- Maryland Community Personal Assistance
- Maryland Medicaid Increased Community Services (ICS) Program
- Michigan Choice Medicaid Waiver Program: Benefits & Eligibility
- Michigan Medicaid Health Link Program / Waiver
- Minnesota’s Elderly Waiver Program
- Minnesota Community Access for Disability Inclusion Waiver
- Mississippi Independent Living Waiver
- Montana HCBS Waiver
- Nebraska Aged & Disabled Waiver
- Nevada HCBW for Persons with Physical Disabilities
- New Hampshire’s Choices For Independence Program
- New Jersey Personal Preference Program
- New York Managed Long Term Care Program Waiver (MLTC)
- New York Community First Choice Option
- North Carolina Community Alternatives Program for Disabled Adults Waiver (CAP/DA)
- North Dakota Aged and Disabled Waiver
- Ohio PASSPORT Waiver
- Ohio MyCare Plan
- Oklahoma Advantage Program Waiver
- Oregon K Plan
- Pennsylvania Department of Aging (PDA) Waiver
- Pennsylvania Services My Way
- Pennsylvania HealthChoices Program
- Rhode Island Global Consumer Choice Compact Waiver
- South Carolina Community Choices Waiver
- South Dakota Hope Waiver
- Tennessee CHOICES in Long-Term Care
- Texas Star Plus Waiver
- Utah Aging Waiver for Individuals Age 65 or Older
- Utah Medicaid New Choices Waiver
- Vermont Global Commitment to Health Waiver
- Vermont CFC Moderate Needs Group Services Program
- Virginia Commonwealth Coordinated Care Plus Waiver
- Washington Community Options Program Entry System Waiver (COPES)
- Washington New Freedom Program
- Washington Medicaid Alternative Care (MAC) Program
- Wisconsin Family Care and Partnership
- Wisconsin IRIS Program
Additional Types of Financial Assistance for Hospital Beds at Home
Obtaining hospital beds for use at home through Medicaid can be a time-consuming process. In the event that an individual is not approved through Medicaid, they may qualify for financial assistance or donations through other programs.
- Veteran's Assistance: Veterans and surviving spouses of veterans who receive VA benefits may be eligible to obtain DME through the VA. Applicants must fill out VA Form 10-10172 Request for Service and return the completed forms to the community care office of their state or local VA facility.
- Local Charities: Some local charities that are dedicated to helping older adults may also provide either low-cost or free hospital beds for in-home use to eligible applicants. For example, Save Our Seniors in Florida is a non-profit organization that helps individuals receive necessary medical equipment, including hospital beds.
- Med-Eq: Med-Eq is a non-profit agency that accepts donated medical equipment, including hospital beds, and distributes it throughout the United States to individuals in need of assistance. The organization's website has functions for both recipients and those looking to donate equipment. Recipients can check the site to find available donations and request items directly from the donation page.