Paying for Home Hospital Beds: Medicare's Policy & ...

24 Jun.,2024

 

Paying for Home Hospital Beds: Medicare's Policy & ...

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Page Reviewed / Updated &#; January 20,

Joshua Iversen, President, Syzygy Financial LLC

Expert Reviewed By:

Medicare&#;s Policy on Home Hospital Beds

Basic home hospital beds may be paid for, in part, by Medicare Part B. Anyone who has Medicare Part B, and has a medical need for a hospital bed in their home, is able to get partial coverage under Medicare&#;s Durable Medical Equipment (DME) policy. DME is defined as medical equipment that can be reused, and a hospital bed falls under this policy. A Medicare enrolled doctor must deem the hospital bed necessary and prescribe it for use in an individual&#;s home.

Medicare will pick up 80% of the amount that is Medicare approved for the purchase of a hospital bed for home use. The individual must cover the remaining 20%. This can be paid out-of-pocket or with help from supplemental insurance, such as Medigap. One must also have met their Medicare Part B deductible, which as of is $185. Medicare will also help to cover the cost of some bed accessories, which may include trapeze bars, mattress covers that are intended to avoid bedsores, and bedside rails.

Rather than buy a home hospital bed straight out, one can also rent a hospital bed and still receive financial assistance from Medicare. With current Medicare regulations, after 13 months of renting, the individual owns the bed.

It&#;s important to note, Medicare will not cover the cost of full electric beds. However, one can pay the difference out-of-pocket between a manual-lift bed and a fully electric one. In addition, Medicare only covers a basic bed, meaning a shape very similar to a twin bed, but not identical.

In order for Medicare to pick up part of the bill, an individual must get the hospital bed from a Medicare approved supplier. If the hospital bed is purchased from a supplier that is not approved, Medicare won&#;t cover any of the cost of the hospital bed. Participating suppliers have Medicare supplier numbers. To find participating suppliers, click here or call 1-800-633-. 

Medicare Advantage Plans, such as a PPO or HMO, may also help to cover the cost of hospital beds. Since plans vary, one will need to call their provider and ask about their specific plan. It is very likely their policies will be the same as Medicare&#;s policy.

Financial Assistance & Payment Options

Medicaid

Since Medicaid is a joint federal and state program, with each state running the program as they see fit within the guidelines set forth by the federal government, rules and regulations about durable medical equipment (DME) such as home hospital beds, is not consistent across the states. That being said, each state has a Medicaid State Plan and most states also have Home and Community Based Services (HCBS) Medicaid Waivers. Both State Plans and Waivers provide assistance to help the elderly avoid nursing home placement. Therefore, Medicaid very often will cover the cost of DME, which includes home hospital beds. As with Medicare, the bed must be deemed necessary by a physician. Learn more about Medicaid and their stance on DME here. 

State Funded, Non-Medicaid Programs

Some states offer non-Medicaid assistance in obtaining durable medical equipment and hospital beds for home use for aging or low income residents. However, it&#;s important to note that these programs vary widely across the board. Click here to learn more about these programs and to see if one is available in your state.

Veterans Options

The Department of Veterans Affairs (VA) offers medical benefits for veterans that also include covering DME, such as home hospital beds. However, once again, a doctor must deem the bed medically necessary.

TRICARE for Life (TFL), a supplemental medical insurance for retired veterans, helps to cover the costs for those enrolled in Medicare that are not covered by Medicare. This holds true for DME, as TFL will pick up the 20% copayment that Medicare requires when purchasing DME. CHAMPVA for Life (CFL) offers the same benefit. But it is meant for spouses at least 65 years of age of vets who have been permanently disabled or killed in service. TRICARE, also for retired vets, also covers hospital beds (both rented and purchased), given they have been prescribed by a doctor.

There are other avenues in which a veteran can get a home hospital bed should a family feel one is required, but is not able to get a prescription. The Veteran-Directed Home and Community Based Services Program (VD-HCBS) allows participants control over what care and services meet their needs. This program should give veterans the flexibility to purchase a hospital bed even if they are unable to have one officially prescribed.

Another option is the Aid & Attendance (A&A) Program. This is a pension program for veterans who need help with their activities of daily living. Their care requirements do not need to be related to their military service. Under A&A, monies can be allocated as the beneficiary sees fit.

In addition, many states also have programs specifically for veterans. For instance, Project MEND is for residents of Texas and provides refurbished home hospital beds and mattresses to veterans and their spouses.

Tax Deductions

One may make a deduction from their federal income taxes in the event they buy a needed home hospital bed for themselves, their spouse or other dependent. It&#;s important to note that deductions for durable medical equipment can only be made in the year that they were purchased. The following examples presume the tax filer has no other medical expenses for the year.

The tax filer can deduct the cost of the bed that is over 10% of their adjusted gross income. If part of the bed was covered by insurance, the tax filer would only be able to deduct the part that was paid out-of-pocket.

Example: Carol&#;s adjusted gross income is $20,000. 10% of $20,000 is $2,000. She purchased a hospital bed for $3,000 out-of-pocket. Therefore, she can deduct $1,000 from her federal taxes.

Example: John has an adjusted gross income in the amount of $15,000. Medicare picked up $2,400 of a $3,000 bed, leaving John $600 to pay (the 20% co-payment). 10% of $15,000 is $1,500. Therefore, since the portion of the hospital bed John has to pay is not over 10% of his adjusted gross income, he cannot deduct this amount from his federal taxes.

Non-Profits & Charities

Depending on the area in which one resides, there may be non-profits and charitable organizations that give away or loan home hospital beds. For instance, the Muscular Dystrophy Association has an equipment loan program. It includes home hospital beds for those who have neuromuscular diseases, such as ALS. To learn more, click here. 

For more information on non-profit organizations that provide DME, click here. 

Home Hospital Bed Costs

The cost of a home hospital bed ranges from $500 to $10,000. The variance is largely due to features and size.

Feature Impacting Price

Electric vs. Manual
Manual Hospital Beds &#; Hospital beds that are manual are the most basic hospital beds and are adjusted via a hand crank. This crank is either attached to the head or the foot of the bed, depending on the model. This type of bed is the most affordable option, which generally starts at about $500.

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Semi-Electric Hospital Beds &#; Semi-electric beds offer more convenience than do manual beds, making it much easier for one to move the position of the bed. With this type of bed, one is able to move the head and foot of the bed electronically, but still has to manually adjust the height of the bed via a crank. The price of a semi-electric bed generally starts at approximately $1,000.

Full-Electric Hospital Beds &#; Full-electric beds offer the ultimate in convenience since all movements / adjustments are made electronically. However, this type of hospital bed is the priciest, starting at around $2,000.

Bed Dimensions 
The length of a standard hospital bed from the top of the bed to the bottom of the bed is 38&#; width by 84&#; length, with the sleep surface being 36&#; width by 80&#; long. However, there are extension kits to extend the length of some hospital beds by 4&#;, which is ideal for persons that are taller than 6&#;. There are also full size hospital beds, which are 54&#; wide by 80&#; long, queen size beds that are 60&#; wide by 80&#; long, and king size beds that are 76&#; wide by 80&#; long. In addition, there are also bariatric beds that come in a larger width of 48&#;. Of course, the larger one goes in size, the more the bed will cost.

Weight Bearing
Most home hospital beds can accommodate weight up to 450 pounds. For individuals who weigh more than this, a bariatric bed is required, which can hold up to 1,000 pounds. Bariatric beds are generally full-electric beds. In general, bariatric beds can cost as much as three times more than standard hospital beds. Bariatric beds also require specific sheets and mattress pads.

Bed Sheets 
Home hospital beds require sheets that are specifically made for this type of bed. This is because a typical hospital bed is the size of a twin bed in width, but is longer in length. One should expect to pay approximately $50 for a set of sheets for a standard home hospital bed.

Mattress Pads 
Home hospital beds also require mattress pads that are specifically made for home hospital beds. A variety of different types of mattresses are available for purchase, including air, gel, and foam. Also, some serve specific purposes, such as adding comfort and helping to prevent sores from body pressure. One can find basic mattress pads starting at approximately $100.

Trapeze Bars 
These bars are used to assist individuals in switching positions, whether it be repositioning to get more comfortable or offering assistance in getting in and out of bed. Bars add $100 &#; $200 in cost.

Rails 
Both manual and electronic rails are available for purchase. One should expect to pay an additional $75 &#; $400.

IV Poles 
For those who require an IV pole, there are both IV poles that attach to hospital beds and freestanding IV poles. One should expect to pay approximately $50.

Others
Other add-ons for home hospital beds include bed trays, table trays, bedpans, call cords, and bed rail pads.

Purchasing Used Home Hospital Beds

Used hospital beds are available and can save one a significant amount of money. In fact, one can purchase a used hospital bed starting at approximately $300. While one can purchase used hospital beds from websites such as Ebay and Craigslist from private owners, these hospital beds generally will not come with any sort of warranty. Many dealers sell refurbished beds, which typically come with a 3-month to 1-year warranty. Make note, used bariatric beds are more difficult to find than standard home hospital beds.

Renting Home Hospital Beds

Renting a home hospital bed (manual, semi-electric, and full-electric) is a great option for those who will only need it for a limited period of time. This is a much more cost efficient option for short-term use. On average, it costs one $200 &#; $500 / month to rent a home hospital bed. One can also find mattresses for rent. Some companies that rent home hospital beds may charge an initial fee for set-up. If this is the case, one should expect to pay an additional $50 to $100.

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Manufacturers

To assist in one&#;s search for home hospital beds, below is a list of reputable manufacturers.

  • Drive
  • DRE
  • Hill-Rom
  • Invacare
  • Medline
  • Stryker

4 Ways to Save Money on Durable Medical Equipment

by: James Fleming

The ever-growing cost of healthcare is rarely more prevalent than in the price tag associated with home medical equipment. If you are in need and looking to save money, don&#;t miss this quick guide:

What is Durable Medical Equipment?

Often referred to by its acronym, DME, durable medical equipment is any tool or device that generates therapeutic benefits for a patient with a diagnosed medical condition or illness. DME is durable which means it can withstand ongoing re-use and can be utilized in the home. Some examples of DME include:

  • Mobility aids like a knee walker scooter, cane, or wheelchair
  • Hospital beds
  • Pressure mattresses
  • Nebulizers
  • Oxygen equipment
  • Hoyer lifts
  • Kidney machines

If you or a loved one experienced an immobilizing injury as the result of a fall, a wheelchair or walker may be prescribed by your doctor. That type of equipment qualifies as DME. One of the most important aspects of DME, at least when it comes to insurance coverage, is that the equipment would be of no use to you if you did not have your medical condition.

How to Save on Durable Medical Equipment?

When it comes to purchasing or leasing DME, pretty much every piece of equipment is available at a retail price for someone looking to pay out of pocket. The costs can be astronomical, however, which is why it is important to either get it covered by health insurance or find deeply discounted options when possible. Keep these helpful tips in mind when shopping:

Get a Doctor&#;s Order

A prescription from your doctor for a specific assistive device will trigger a process by which insurance connects you with local providers and covers some or all of the cost of the equipment. While the journey from seeing your doctor and receiving the equipment can take anywhere from a couple of weeks to a couple of months depending on the provider and type of device, this is the primary way to save money.

Similar to writing an order for home health care, a prescription for a medical device that aids your specific condition needs to be written by your doctor. In addition to the order, your doctor will also have to provide medical history information and evidence that effectively backs up their recommendation. If approved, an insurance company will have a local medical equipment company contact you in regards to fulfilling the order.

Check a Local Lending Library

You might be surprised to find out that lots of senior-focused organizations like the National Council on Aging and elder resources nonprofits offer free DME lending programs for adults over 65. The programs are donation-based but can be a true asset, especially if you need temporary medical equipment, like crutches.

These types of programs collect gently-used equipment that other people have donated and then clean and repair it as needed for lending. Most often, if you are in need, you can get on a list to be notified when the tool or device you require becomes available. You may be asked to sign a form saying you are borrowing the equipment and will return it when you are finished using it.

Sometimes churches and regional medical resource centers will also offer medical equipment exchange programs so it is definitely worth looking around. Either search online or contact your nearby Council on Aging to see what programs they may know about.

Look Online

In the digital age, it&#;s no surprise that an array of discounted, quality medical equipment can be found online. Whether it&#;s on big sites like Amazon or independent DME distributors, your chances of finding the item you need on the internet are high.

When shopping online, make sure to watch out for steep shipping costs and always check product reviews, they can be illuminating and save you an expensive purchase you regret.

Try the Pharmacy

With senior care demand on a rapid rise, more and more pharmacies are taking cues to stock up on home medical supplies that can effectively improve a senior&#;s quality of life. Everything from mobility aids to bed rails, grab bars, toilet seat risers, transfer benches, overbed tables, even lift chair recliners are available at pharmacies or their online websites.

In addition to purchasing items in-store when they are on sale, one way to save money is to sign up for the store&#;s rewards program. If you&#;re going to be picking up prescriptions and medical equipment there, might as well earn rewards points that qualify you for special coupons and cashback the more you shop there. Pharmacies often include you in sweepstakes to earn even bigger savings too simply for completing things like online surveys.

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