Medicare's Coverage of Lift Chairs

Medicare Part B covers a lift chair recliner — also called a power lift recliner — but only when a doctor prescribes it as medical equipment and you meet specific conditions. Medicare does not pay for a lift chair you buy for comfort or convenience. The chair must be ordered through a supplier enrolled in Medicare, and your doctor must document that you cannot sit down or stand up safely without mechanical help.

The coverage is called Durable Medical Equipment (DME) benefit. Medicare pays 80 percent of the approved amount after you have paid your Part B deductible. You are responsible for the remaining 20 percent, plus any cost above what Medicare considers reasonable and necessary.

Not every lift chair qualifies. Medicare covers the chair itself — the lifting mechanism and the reclining seat — but the coverage depends on your medical need and your doctor's documentation of that need.

Key Takeaways

  • Your doctor must write an order stating that you need a lift chair for a medical reason, such as severe arthritis, mobility problems, or a recent surgery that makes standing and sitting unsafe.
  • You must use a Medicare-enrolled DME supplier to order the chair; buying one on your own and asking Medicare to reimburse you will not work.
  • Medicare pays 80 percent of the approved amount after your Part B deductible is met, leaving you to pay 20 percent plus any amount above Medicare's approved price.
  • Your doctor's order must include specific medical justification; a prescription that straightforward says "lift chair" without explanation is likely to be denied.
  • The chair must be for your own use in your home; Medicare does not cover lift chairs for facilities or for resale.

What Your Doctor Needs to Document

Medicare requires your doctor to state in writing why you need a lift chair and why other options will not work. Common medical reasons include severe arthritis in the hips or knees, recent hip or knee surgery, spinal cord injury, severe weakness, or a condition that makes it unsafe for you to lower yourself into a regular chair or push yourself up from one.

The order should describe your specific limitation — for example, "patient cannot rise from a seated position without information due to bilateral knee osteoarthritis" — rather than a general statement. Medicare reviewers use this documentation to decide whether the lift chair is medically necessary for you, not just convenient.

If your doctor is unsure what to write, ask them to contact the DME supplier. Many suppliers have templates or can tell your doctor's office exactly what Medicare requires in the order.

How to Order a Lift Chair Through Medicare

Start by asking your doctor for a written order. Once you have it, contact a Medicare-enrolled DME supplier in your area. You can find suppliers by calling Medicare at 1-800-MEDICARE or by searching the Medicare Supplier Directory online at dmepos.cms.gov.

Give the supplier your doctor's order and your Medicare information. The supplier will submit the order to Medicare for review before the chair is delivered. This review usually takes one to two weeks. Medicare will either approve the order, deny it, or ask for more information from your doctor.

Do not buy the chair yourself and then ask Medicare to pay you back. Medicare only pays when the order goes through an enrolled supplier and is approved before delivery.

What Medicare Considers Reasonable and Necessary

Medicare has an approved amount for lift chairs, which varies by region. If the supplier's price is higher than Medicare's approved amount, you pay the difference out of pocket. The supplier must tell you the price and Medicare's approved amount before you agree to the order.

Medicare also requires that the chair meet certain standards — it must be a standard lift chair recliner, not a luxury model with extra features like heat, massage, or premium upholstery. Those add-ons are not covered and you pay for them separately.

If Medicare denies your order, the supplier or your doctor can ask for a review. This is called an appeal, and you have the right to request one if you disagree with the decision.

Your Out-of-Pocket Costs

Your costs depend on whether you have met your Part B deductible for the year. If you have not, you pay the full deductible first (currently $226 per year, though this amount changes yearly). After the deductible is met, Medicare pays 80 percent and you pay 20 percent of the approved amount.

For example, if Medicare's approved amount is $3,000 and you have met your deductible, Medicare pays $2,400 and you pay $600. If the supplier's price is $3,500, you also pay the extra $500 out of pocket.

Some people have a Medigap or Medicare Advantage plan that covers part or all of the 20 percent. Check your plan documents or call your plan to see what it covers for DME.

When Medicare Does Not Cover a Lift Chair

Medicare will deny coverage if your doctor does not provide medical justification, if the order is incomplete, or if the reviewer decides the chair is not medically necessary for your condition. Denial is common when the order straightforward says "patient requests lift chair" without explaining why the patient cannot sit or stand safely.

Medicare also does not cover lift chairs for people in nursing homes or assisted living facilities — those facilities are responsible for providing the equipment residents need. If you move to a facility, you cannot use Medicare to pay for a lift chair there.

If your claim is denied, ask the supplier or your doctor to file an appeal. You can also contact your State Health Insurance information Program (SHIP) for help understanding the denial and deciding whether to appeal.

Alternatives If Medicare Does Not Cover Your Chair

If Medicare denies your order, you have other options. Some Medicaid programs cover lift chairs — check with your state's Medicaid office. Veterans may be covered through the VA. Some charitable organizations and disease-specific foundations offer financial help or donated equipment.

You can also buy a lift chair out of pocket. Prices range widely depending on the model and features. Some suppliers offer payment plans. A few retailers offer used or refurbished lift chairs at lower cost, though you should inspect the chair carefully before buying.

If cost is a barrier, ask your doctor or social worker about local resources. Some communities have equipment loan programs or charities that help seniors obtain mobility aids.

Frequently Asked Questions

Can I use my Medicare Advantage plan instead of Original Medicare to cover a lift chair?

Yes. Medicare Advantage plans must cover at least what Original Medicare covers for DME, though some plans cover more. Contact your plan to find out what it covers for lift chairs and whether you need prior approval before ordering.

What if my doctor says I need a lift chair but Medicare says I don't?

You can ask for an appeal. The supplier or your doctor can file a reconsideration request within 180 days of the denial. If you disagree with the appeal decision, you have the right to a hearing before an administrative law judge. SHIP can help you understand your appeal rights.

Does Medicare cover the delivery and setup of the lift chair?

Delivery is usually included in the price the supplier charges, and Medicare's approved amount includes delivery. Setup and instruction on how to use the chair are also typically included. Ask the supplier before you order to confirm what is included.

Can I rent a lift chair instead of buying one?

Yes. Medicare covers rental of DME, including lift chairs, and the rules are the same — your doctor must prescribe it and you must use an enrolled supplier. Rental may cost less upfront, though long-term rental can eventually cost more than purchase. Ask the supplier about both options.

What happens if I no longer need the lift chair?

If you bought it, it is yours to keep, sell, or donate. If you rented it, contact the supplier to arrange return. You are not required to return a purchased chair to Medicare.