Medicare and Mattresses

Medicare and Mattresses

It’s not an easy task to make sure you have the right mattress which offers you both the required back support and comfort.

There are so many mattresses on the market; to find the right one people have to make an extensive research and test it where possible. 

Making the mattress selection process even more difficult is quality, since mattresses are typically expensive products and require a substantial investment on your part.

It is even more difficult for those on medications to find a suitable mattress. Fortunately, Medicare Part B has provisions that will help to offset your mattress bill.

Medicare Part B offers coverage of Reliable Medical Equipment (DME). Medicare Part B covers the cost or much of the medically required, long-lasting medical equipment, if your doctor has approved the DME for use at home.

DME coverage doesn’t even refer to mattresses.

Blood sugar testing and test strips, canes, crutches, infusion pumps, breathing supplies, and wheelchairs are just some of the extra DMEs that could be protected under Part B of Medicare.

And how does reporting of the DME work?

Was your medicare coverage paying the DME’s maximum cost? Is there any limits?

The answers to these three questions will help you get a better understanding of how Medicare Part B DME coverage operates, and what you need to do to get a new mattress via Medicare Part B.

The first thing you need to learn is that DME coverage typically has three different payment plans.

With any DME authorized, you’ll have to pay 20 percent of the DME’s overall approved medicare bill. The premium for Medicare Part B must be for the cost.

The rest of the expenses would then be covered by Medicare Part B. Medicare Part B, however, can impose those restrictions depending on the equipment and the time it is required.

Some DME coverage would allow you to rent out the equipment. For other situations you might need to buy the equipment.

For some cases you have the leeway to decide whether to rent or lease or not.

Medicare Part B only protects the DME if you are enrolled in Medicare and the doctor who has approved the DME for your use and the DME manufacturer.

To be licensed in medicine, all physicians and manufacturers have to follow rigorous criteria.

When the doctor or provider is not participating in Medicare, Medicare Part B does not cover all of the expenses and the DME does not have a cost cap imposed on the drug.

Suppliers can also be enrolled in Medicare, but do not participate directly in Medicare.

When they are deemed to be participating providers, they will agree and supply you with the costs that medicare sets for the DME.

Suppliers that are registered but do not participate, however, have the right to decline to supply you with the DME at the medicare set rate, and can charge you up to the full DME amount.

To get an adjustable Hospital bed mattress by Medicare, you need to find a manufacturer that participates.

When you’re uncertain of finding a supplier willing to meet your DME needs, you can search the website to locate a supplier near you.

Note that while certain manufacturers will be enrolled in Medicare, they would not be subject to the Medicare Price restrictions if they are not actively involved.