Medicare's Coverage of Stairlifts

Medicare Part B covers stairlifts, but only under specific conditions. The device must be prescribed by your doctor as medically necessary, and it must be installed in your home. Medicare classifies stairlifts as durable medical equipment (DME), the same category as wheelchairs, walkers, and oxygen machines.

The catch: Medicare will only pay if your doctor documents that you cannot safely use stairs due to a medical condition — not straightforward because stairs are inconvenient or you are aging. Your doctor must write an order stating the medical reason, and you must have a mobility limitation that makes climbing stairs unsafe or impossible.

If Medicare determines the stairlift is medically necessary, you pay 20 percent of the approved amount after you meet your Part B deductible. Medicare pays the remaining 80 percent directly to the DME supplier. The actual out-of-pocket cost depends on the stairlift model and your supplier's pricing.

Key Takeaways

  • Your doctor must prescribe the stairlift and document a medical reason — age alone or general mobility concerns do not may have access to.
  • Medicare covers 80 percent of the approved amount after your Part B deductible is met; you pay 20 percent.
  • The DME supplier must be Medicare-enrolled, and you should confirm they accept Medicare assignment before ordering.
  • If Medicare denies the claim, you can request a reconsideration within 180 days by submitting additional medical documentation.
  • Medicaid may cover stairlifts in some states if you do not may have access to for Medicare or need additional help with costs.

How to Get Your Doctor's Order

Start by scheduling an appointment with your primary care doctor or a specialist who knows your medical history — a cardiologist, neurologist, orthopedic surgeon, or physical therapist. Bring a list of your mobility problems: difficulty climbing stairs, pain, shortness of breath, balance issues, or falls. Be specific about what happens when you try to use stairs.

Your doctor will examine you and decide whether a stairlift is medically necessary for your condition. If they agree, they will write a prescription or order that includes the medical reason. Common reasons Medicare accepts include severe arthritis, heart disease, neurological conditions like Parkinson's disease, post-surgical recovery, and balance disorders.

Ask your doctor to send the order directly to a Medicare-enrolled DME supplier, or ask for a copy to give to the supplier yourself. Do not buy the stairlift before you have the order in writing — Medicare will not pay for equipment ordered without a prescription.

Choosing a Medicare-Enrolled DME Supplier

Not every stairlift company accepts Medicare. You must use a supplier enrolled in the Medicare program. You can search for enrolled suppliers in your area on the Medicare DME Supplier Locator at the Centers for Medicare & Medicaid Services website, or call 1-800-MEDICARE to ask for a list.

When you contact a supplier, ask three questions: Do they accept Medicare assignment? Can they bill Medicare directly? What is your 20 percent cost-share? Assignment means the supplier agrees to accept Medicare's approved amount as full payment (except for your 20 percent). If they do not accept assignment, you may owe more.

Get a written quote from at least two suppliers before deciding. The quote should list the stairlift model, installation cost, and your estimated out-of-pocket expense. Some suppliers charge extra for delivery, installation, or removal of an old stairlift — ask whether these are included in the price or billed separately.

What Happens After You Order

Once you choose a supplier and they have your doctor's order, they will submit a claim to Medicare on your behalf. Medicare reviews the claim to confirm the order is valid and the stairlift is medically necessary. This review usually takes one to two weeks.

If Medicare approves the claim, the supplier will contact you to schedule installation. You will pay your 20 percent cost-share at the time of installation or shortly after. The supplier bills Medicare for the remaining 80 percent.

If Medicare denies the claim, the supplier must send you a notice explaining why. Common reasons for denial include: the doctor's order did not include a medical reason, the reason given does not meet Medicare's criteria, or the supplier is not enrolled in Medicare. You have the right to request a reconsideration within 180 days by submitting additional medical records or a letter from your doctor explaining why the stairlift is necessary.

When Medicare Will Not Pay

Medicare does not cover stairlifts ordered only for convenience or safety preference. If your doctor cannot document a medical condition that makes stairs unsafe, Medicare will deny the claim. Age alone, general weakness, or wanting to avoid climbing stairs are not medical reasons.

Medicare also will not pay if you buy the stairlift yourself before getting a prescription. Once you own it, Medicare considers it your personal property and will not reimburse you. Always get the doctor's order and Medicare's approval before purchasing.

Rental stairlifts are sometimes covered, but purchase is more common. If you need a stairlift temporarily — for example, during recovery from surgery — ask your doctor whether rental makes sense and whether Medicare will cover it. Coverage rules for rental are the same as for purchase.

Other Ways to Pay If Medicare Does Not Cover It

If Medicare denies your claim and you cannot afford the full cost, explore other options. Medicaid covers stairlifts in some states if your income and assets fall below the state limit. Contact your state Medicaid office to ask whether stairlifts are covered and what the income threshold is.

Some nonprofits and community organizations offer grants or low-cost loans for home modifications, including stairlifts. The National Association of Area Agencies on Aging can connect you with local programs. Your city or county aging department may also know of funding sources.

If you have a supplemental insurance plan (Medigap), check your policy to see whether it covers the 20 percent cost-share. Most Medigap plans do not cover DME, but a few do — it depends on the plan letter.

Frequently Asked Questions

Does Medicare cover curved stairlifts or only straight ones?

Medicare covers both straight and curved stairlifts if they are medically necessary. Curved stairlifts cost more, so your 20 percent cost-share will be higher. The supplier must still be Medicare-enrolled and your doctor must still write an order.

What if I fall and get injured before Medicare approves my stairlift?

Medicare will not reimburse you for injuries or accidents that happen while waiting for approval. This is why it is important to ask your doctor to prioritize the order and to contact Medicare if the review is taking longer than two weeks. In the meantime, ask family or friends to help you use stairs, or temporarily sleep on a lower floor if possible.

Can I use my Medicare Advantage plan to pay for a stairlift instead of Original Medicare?

Yes. Medicare Advantage plans must cover the same DME as Original Medicare, but they may have different rules about which suppliers you can use or what your cost-share is. Call your plan's customer service number to ask how stairlifts are covered under your specific plan.

What if my stairlift breaks after Medicare pays for it?

Repairs and maintenance are your responsibility once Medicare has paid. Some suppliers offer maintenance plans or warranties — ask about these when you order. If the stairlift becomes unusable, you would need a new doctor's order and would go through the Medicare process again.

Do I need prior authorization from Medicare before ordering?

No formal prior authorization is required, but the supplier will submit the claim to Medicare before or shortly after installation. It is a good idea to call Medicare at 1-800-MEDICARE before ordering to confirm that your doctor's order meets their requirements, so you do not install a stairlift and then have the claim denied.