Does Medicare Cover Lift Chairs?
- Lift chairs may benefit seniors who need help transitioning between sitting and standing. Learn the basics of purchasing lift chairs through Medicare.
Older adults who have difficulty transitioning between sitting and standing may benefit from a lift chair, but these recliners often come with price tags that run into the thousands of dollars. If you’re a Medicare enrollee who's interested in adding this helpful assistive device to your home, keep reading to learn how you can purchase lift chairs through Medicare, what's involved in reimbursement and how to choose the right unit for your unique needs.
What Is a Lift Chair?
A lift chair is a recliner that features a powerful motorized lift mechanism, which raises and lowers the seat. Lift chairs are designed to assist the user into a sitting position so they can comfortably recline and help them stand by lifting them back into an upright position. They're usually operated by remote control so the user doesn't have to reach for a button or lever.
Lift chairs are sometimes referred to as power-lift recliners or pop-up chairs. They shouldn’t be confused with stair lifts, which carry users up flights of stairs, or patient lifts, which help caregivers transfer an individual from a bed to a wheelchair.
Who Can Benefit From a Lift Chair?
Anyone who experiences mobility or balance challenges may benefit from using a lift chair, which assists the user into an upright position when they’re ready to get up. These recliners are especially useful for people who are generally ambulatory but have difficulty transitioning from sitting to standing positions.
Because many lift chairs can be adjusted into a nearly infinite array of positions, including flat, they can also be used for sleeping and may benefit individuals who need to keep their legs raised overnight. They can also be an ideal sleeping solution for patients recovering from shoulder, arm or leg surgeries, making it easier to remain comfortable while immobile.
Chairs that include additional therapeutic features, such as heat and massage, may also serve as an affordable alternative to bathtub modifications for individuals receiving heat or massage therapies.
Are Lift Chairs Covered by Medicare?
Lift chairs are considered durable medical equipment and may be covered by Medicare if specific criteria are met:
- The beneficiary must have coverage through either Medicare Part B or Medicare Advantage.
- The device was prescribed by a Medicare-approved physician or a Certificate of Medical Necessity was obtained.
- The chair must be purchased at an approved supplier that accepts Medicare assignment.
Enrollees who live in skilled nursing facilities do not qualify for lift chairs through Medicare. These plans also won’t cover lift chairs for beneficiaries who have previously used benefits to cover scooters or power or manual wheelchairs unless a physician verifies that your mobility has improved sufficiently.
Enrollees who have Medicare Advantage should consult their providers for more information about coverage through their individual plans.
What Constitutes Medical Necessity?
Lift chairs must be deemed medically necessary for Medicare reimbursement. A beneficiary must meet the following requirements for a lift chair to be considered a medical necessity:
- Diagnosed with a neuromuscular disease or severe arthritis of the knee or hip
- Unable to get up from a sitting position in a regular chair
- Able to walk independently or with the use of a cane or walker
- Receiving treatment aimed at improving or slowing the deterioration of their condition that requires the use of the seat-lift chair
Does Medicare Cover the Entire Cost of a Lift Chair?
Medicare doesn’t cover the entire cost of a lift chair. Typically, only the seat-lifting mechanism is considered reimbursable under Medicare Advantage or Part B plans, and the coverage amount varies by state. Beneficiaries who have met their annual deductible may still be responsible for paying 20% of the Medicare-approved cost of the mechanism. You'll probably also have to cover the price of the furniture portion of the chair. That includes the frame, cushions and upholstery.
How Do I Get a Lift Chair Through Medicare?
If you want to get a lift chair through Medicare, the first step is to get a doctor’s prescription or Certificate of Medical Necessity. This may require an in-person visit to your physician.
Once you’ve obtained the prescription, find a Medicare-approved supplier who can match you with the appropriate chair. This supplier may need your physician to fill out additional paperwork that answers questions about your condition. Once you’ve chosen a chair, the supplier will submit your Medicare claim. Depending on your needs, Medicare may dictate whether you can purchase a lift chair or must rent the unit.
Are All Lift Chairs the Same?
No. There are several types of lift chairs available:
- Two-position lift chairs: Typically the least expensive option, these recliners may be set in a 90-degree upright position or reclined to a 45-degree angle to elevate your legs.
- Three-position lift chairs: In addition to upright and 45-degree reclining positions, three-position chairs may be fully reclined into an almost entirely flat position.
- Infinite-position lift chairs: With separate motors operating the back recliner and the leg elevator, infinite-position lift chairs are the most expensive of the lift chairs but offer a nearly endless array of reclining options.
Chairs also come in a variety of sizes, fabrics and colors to suit your body type, lifestyle and general household preferences.
How Do I Choose the Right Lift Chair?
Whether you visit a dealer in person or online, be prepared to discuss your medical, household and lifestyle needs and preferences. A knowledgeable supplier can help you choose the right chair.
In addition to accommodating specific medical needs, you may want to consider the following factors when choosing a lift chair:
- Body type. For a chair to be comfortable and function optimally, it shouldn’t be too big or too small, so select a chair that’s designed for your height and weight. Remember: your feet need to touch the floor when the chair is in the lifted position.
- Space restrictions. Your chair should fit comfortably into your home. When shopping for a chair, bring the relevant measurements, including doorways the unit must fit through. Ask your supplier how much space your lift chair needs to fully function.
- Specific uses. Consider how you plan to use your chair. Will it just be used for watching TV or will you be sleeping in it regularly?
- Lift chairs come in a variety of fabrics. You should consider both aesthetics and functionality when choosing a type of upholstery.
- Optional therapeutic benefits. Some chairs offer additional features such as heat and massage features or cupholders.
Is There Additional Help for Out-of-Pocket Costs?
For seniors who can't afford the out-of-pocket costs associated with lift chairs, there may be help. Supplemental insurance known as Medigap, which is offered through private insurance companies, may help cover coinsurance and copayments for enrollees in traditional Medicare plans. To find out the specifics of your individual coverage, contact your insurance carrier directly.