A good night’s sleep is critical for your health, and an unsuitable mattress can make this challenging. If you suffer from specific medical problems, such as back pain, a good mattress is even more important. A new mattress can be rather costly, and many seniors are unable to buy one. If you’re on Medicare you may be wondering if you can get a new mattress. The answer is yes! You can get a new mattress with Medicare. There are a few different ways to go about it but the most important thing is to make sure that you get a mattress that is comfortable and will help you get a good night’s sleep.
Medicare covers almost all seniors (aged 65 and over). While Medicare is most commonly linked with paying medical expenditures for things like doctors and hospitals, it may also assist cover health and medical-related expenses. Durable Medical Equipment (DME) is the term for such eligible products, and Medicare will cover the majority of the cost.
You must be enrolled in Medicare Part B to be eligible for DME coverage. This necessitates the submission of an application (registration is not automatic like Part A) as well as the payment of a monthly fee.
Mattresses are classified as DMEs
When it comes to whether or not DME Medicare will authorized a mattress as a coverage or not, there are two primary elements to consider. First, the patient’s health and scenario must meet certain criteria, which will be explained in further detail in the next section. Second, the mattress itself must meet the requirements. A recognized pressure-relieving mattress is the only type of mattress that qualifies as a DME.
Medicare has to identify it as such. These mats relieve discomfort caused by medical diseases including arthritis and other orthopedic issues. To put it another way, the mattress would be part of medical treatment for the patient – it couldn’t merely be for “comfort.” The following is a list of some of the best mattresses of this sort.
Regulations and Problems Pertaining Patient Eligibility
In addition to the mattress, Medicare must declare the patient as qualified for the coverage. The patient needs to demonstrate that the mattress is a “medical necessity.” The following actions are here to help you achieve this:
- A doctor must formally prescribe the mattress as a medical necessity for the patient and support that declaration with relevant medical paperwork.
- The doctor must be Medicare-approved and must have seen the patient in real within the previous six months.
- You will need to use the mattress at home (however if the patient is in a sibling’s home or a care facility, he can take it there).
The following regulations apply in addition to the ones listed above:
- You may only get the mattress from a Medicare-approved and cooperating medical products vendor.
- You must submit the claim for coverage in advance and get official Medicare preapproval.
- If the claim is for a replacement DME mattress, you need to have acquired the old DME mattress for at least five years.
Factors Influencing Payment
The following rules apply if Medicare accepts the mattress as a covered product:
- You need to pay any deductible on Part B insurance first before Medicare makes the payments.
- Medicare covers 80% of the mattress’s permitted cost as a standard payment method (payment directly goes to the supplier) and for the patient to cover the remaining 20%.
- For the mattress, Medicare will only pay 80% of the “Medicare authorized” amount. You will be responsible for the difference if you agree to higher pricing.
Alternating Pressure Low Air Loss Mattress System by Drive Medical
This is a device that can regulate the mattress’s pressure, providing changing or constant pressure as necessary. A silent electric pump, generally controlled by a hand-held control device, circulates air and directs or adjusts mattress pressure according to the patient’s demands.
5 Zone Therapeutic Support Mattress by Drive Medical
The five zones mattress are meant to equally distribute pressure on the mattress, relieving discomfort and minimizing bed sores as a primary medical purpose. With its robust foam core, it is both pleasant and durable. It’s also ideal for use as a medical mattress because it’s both waterproof and anti-microbial.
PrevaMatt Defend Pressure Relief Mattress by Joerns
This pressure-relieving mattress alleviates pressure-related issues including pressure ulcers and wounds (bed sores). It contains two layers of viscoelastic foam. It can easily shift with and envelop your body, reducing pain and suffering.
Pressure Relief Mattress by ThevoRelief
This smooth and comfortable pressure-relieving mattress provides maximum pain and discomfort alleviation thanks to its design. Its distinctive wing suspensions assist ease pain, and it’s an excellent mattress for people who have chronic medical concerns.
At the end
If you have Medicare you may be wondering if you can get a new mattress through the program. As we detailed in this article, The answer is yes, you can get one. While Medicare does not cover mattresses as standard equipment, they cover them under certain circumstances. Your doctor has to prescribe the mattress for you due to a medical condition. Medicare will cover it as part of your medical care. There are also some private insurance plans that cover mattresses so it’s worth checking with your insurer to see if they offer any coverage.