Medicare covers hospital beds, but only under specific conditions and through a defined process

Medicare Part B covers a hospital bed if your doctor writes an order saying you need it for a medical reason — not just for comfort or convenience. The bed must be medically necessary, which means your condition makes a regular bed unsafe or impractical. Medicare calls this piece of equipment durable medical equipment, or DME. You pay 20 percent of the approved amount after you meet your Part B deductible; Medicare pays 80 percent.

The catch is that you cannot walk into a medical supply store and buy one yourself, then ask Medicare to reimburse you. You have to follow a specific path: your doctor orders it, a Medicare-approved DME supplier provides it, and the supplier bills Medicare directly. If you skip any step, you may end up paying the full cost yourself.

Key Takeaways

  • Your doctor must write an order stating the bed is medically necessary for your condition; Medicare does not cover beds ordered for comfort alone.
  • You must rent or buy the bed from a Medicare-approved DME supplier, not from a regular furniture store or online retailer.
  • Medicare pays 80 percent of the approved amount after your Part B deductible is met; you pay 20 percent.
  • The DME supplier submits the claim to Medicare on your behalf, so you do not have to file paperwork yourself.
  • If Medicare denies the claim, you have the right to appeal, and your doctor can provide additional medical information to support the order.

What counts as medically necessary for a hospital bed

Medicare approves hospital beds for people who cannot safely use a regular bed because of their medical condition. Common reasons include severe arthritis that makes it painful to lie flat, heart or lung disease that requires the head elevated at all times, or mobility problems that make getting in and out of a regular bed dangerous. If you have had recent surgery or a hospital stay and your doctor says you need the bed during recovery, that also qualifies.

What does not may have access to is needing a bed that is easier to get out of, or wanting one because it is more comfortable. Medicare reviewers look at your diagnosis, your doctor's notes about why the regular bed is unsafe, and whether the hospital bed directly addresses that safety issue. If your doctor's order does not explain the medical reason clearly, the claim may be denied.

How to get a hospital bed through Medicare

Start by talking to your doctor. Tell them you are having trouble with your regular bed because of your condition. If your doctor agrees a hospital bed would help, they will write an order that includes your diagnosis, why the bed is medically necessary, and how long you will need it. Your doctor does not have to use special forms — a note in your medical record is enough, though some doctors use Medicare's official order form.

Next, find a Medicare-approved DME supplier. You can search for one at the Medicare DME Supplier Directory on Medicare.gov, or call 1-800-MEDICARE and ask for suppliers in your area. When you contact the supplier, give them your doctor's order and your Medicare information. The supplier will verify your coverage, check that you have met your deductible, and tell you what your out-of-pocket cost will be. They then submit the claim to Medicare and handle the billing.

The supplier will deliver and set up the bed. If Medicare approves the claim, you pay your 20 percent share. If Medicare denies it, the supplier will tell you, and you can ask your doctor to provide more detail about why the bed is necessary.

Renting versus buying a hospital bed

You can either rent or buy a hospital bed through a Medicare-approved supplier. Rental is usually the better choice if you need the bed for a few weeks or months — you pay a monthly rental fee, and Medicare covers 80 percent of that fee. Once you have rented for about 13 months, you own the bed, and rental payments stop.

If you buy the bed outright, Medicare covers 80 percent of the purchase price. Buying makes sense if you know you will need the bed long-term or if you already own one and want Medicare to reimburse part of the cost. However, if you bought the bed before getting a doctor's order, Medicare will not reimburse you — the order must come first.

The supplier can explain which option costs less in your situation. Some suppliers offer both, so ask about the total cost under each plan before you decide.

What happens if Medicare denies your claim

If Medicare denies the claim, the supplier will send you a notice called a Explanation of Benefits, or EOB. It will say why Medicare said no — usually because the doctor's order did not clearly explain the medical need, or because the diagnosis alone does not meet Medicare's criteria for a hospital bed.

You have the right to appeal. Ask your doctor to write a more detailed note explaining exactly why you cannot use a regular bed safely. Your doctor might describe your mobility limits, pain level, or how the hospital bed prevents falls or pressure sores. Send this note to Medicare along with your appeal. Many denials are reversed once Medicare sees the full medical picture.

If you disagree with the appeal decision, you can request a review by an independent reviewer who is not part of Medicare. The supplier or your doctor can help you file this request.

Medicare Advantage and hospital beds

If you have a Medicare Advantage plan instead of Original Medicare, your coverage for hospital beds may be different. Some Advantage plans cover them the same way Original Medicare does; others have different rules or require you to use specific suppliers. Call your plan's customer service number — it is on your insurance card — and ask whether hospital beds are covered and what you need to do to get one.

Your doctor still needs to write the order, and you still use a Medicare-approved supplier. But your plan may require prior approval before the supplier orders the bed, or may have a different cost-sharing amount. Check with your plan before you contact a supplier.

Frequently Asked Questions

Can I buy a hospital bed online and have Medicare pay for part of it?

No. The supplier must be Medicare-approved, and they must submit the claim to Medicare themselves. If you buy from a non-approved seller, Medicare will not reimburse you. Use the Medicare DME Supplier Directory to find an approved supplier near you.

What if my doctor says I need a hospital bed but Medicare denies it?

Ask your doctor to provide more detail about your medical condition and why a regular bed is unsafe. Common reasons Medicare approves appeals include severe arthritis, heart or lung disease requiring elevation, or recent surgery. Your doctor can send this information to Medicare as part of your appeal.

Do I have to pay anything upfront, or does the supplier bill Medicare first?

The supplier bills Medicare first. Once Medicare approves and pays their 80 percent, you receive a bill for your 20 percent share. If Medicare denies the claim, the supplier will tell you that you are responsible for the full cost.

How long does it take Medicare to approve a hospital bed?

It usually takes one to two weeks. The supplier submits the claim with your doctor's order, and Medicare reviews it. If your doctor's order is clear and complete, approval is faster. If Medicare needs more information, it may take longer.

Can I keep the hospital bed if I move to a nursing home or assisted living?

If you own the bed, it is yours and you can take it with you. If you are renting, contact the supplier to arrange pickup or transfer. Some suppliers can deliver to a new location. If you no longer need the bed, the supplier will pick it up and your rental payments stop.