When Medicare Covers Hospital Beds and When You Pay Out of Pocket

What Medicare covers for hospital beds

Medicare Part B covers a hospital bed if your doctor writes an order saying you need it for a medical reason — not just comfort or convenience. The bed must be medically necessary, which means your condition makes a regular bed unsafe or impossible to use. Examples include severe arthritis that makes it hard to get in and out of bed, or a condition where you need the head raised to breathe.

Medicare pays 80% of the approved amount after you meet your Part B deductible. You pay the remaining 20%. The supplier must be enrolled in Medicare, so you cannot buy a bed from any store and ask Medicare to reimburse you — the supplier has to bill Medicare directly.

The bed itself is considered durable medical equipment, or DME. This is the same category that includes wheelchairs, walkers, and oxygen machines. Medicare's rules for DME are strict: the equipment must be something you can use repeatedly, it must be prescribed by a doctor, and it must be medically necessary for your condition.

Key Takeaways

Your doctor must write an order stating the medical reason you need a hospital bed, not just that you want one.
The DME supplier must be enrolled in Medicare and bill Medicare directly — you cannot buy a bed elsewhere and ask for reimbursement.
Medicare pays 80% of the approved amount after your Part B deductible; you pay 20%.
You can rent a hospital bed month to month, and Medicare covers rental the same way it covers purchase.
If Medicare denies your claim, you have the right to ask for a review, and your doctor can provide additional medical information to support the request.

How to get your doctor's order

Start by talking to your doctor about whether a hospital bed would help your condition. Be specific about what makes a regular bed difficult — for example, pain when lying flat, trouble breathing when horizontal, or inability to move in and out of bed safely. Your doctor will decide whether the medical reason is strong enough to justify the cost and whether a hospital bed is the right solution.

If your doctor agrees, they will write a prescription or order that includes the medical reason, how long you need the bed, and any special features (such as a bed that raises the head or lowers the foot). This order goes to a Medicare-enrolled DME supplier, not to you. You do not need to submit it yourself.

Your doctor's office may have a relationship with a specific DME supplier and will send the order there. If not, ask your doctor which suppliers they recommend, or you can search for Medicare-enrolled DME suppliers in your area on the Medicare website.

Renting versus buying a hospital bed

You can either rent or buy a hospital bed, and Medicare covers both the same way — 80% after your deductible. Most people rent because the upfront cost is lower and you do not have to store or dispose of the bed later.

Rental typically costs between $50 and $150 per month depending on the bed's features and your location, though prices vary. You can rent month to month and stop whenever you no longer need it. If you rent for several months, the total rental cost may exceed the purchase price, but you avoid a large upfront expense.

If you buy, you own the bed outright after paying your share. Some people choose to buy if they know they will need the bed for a long time or if they want to keep it after Medicare coverage ends. The purchase price is usually between $500 and $3,000 depending on the bed's features.

What happens if Medicare says no

Medicare may deny your claim if the supplier did not bill correctly, if your doctor's order did not include a clear medical reason, or if Medicare's medical reviewer decides the bed is not medically necessary for your condition. You will receive a notice called an Explanation of Benefits, or EOB, that explains why the claim was denied.

You have the right to ask for a review. This is called an appeal. You have 120 days from the date on the EOB to request one. Contact the DME supplier or call Medicare at 1-800-MEDICARE to start the appeal process.

During the appeal, your doctor can send additional medical information explaining why the bed is necessary for your specific condition. For example, if Medicare said the bed was not medically necessary, your doctor might send notes about your diagnosis, your mobility limitations, and why a regular bed creates a safety risk. Many denials are overturned after an appeal with supporting medical information.

Medicare Advantage and hospital beds

If you have a Medicare Advantage plan instead of Original Medicare, the rules for hospital bed coverage are similar but not identical. Medicare Advantage plans must cover at least what Original Medicare covers, but they can have different deductibles, copays, and supplier networks.

Contact your Medicare Advantage plan directly to ask whether a hospital bed is covered under your specific plan and what your out-of-pocket cost will be. You will still need a doctor's order, and the supplier must be in your plan's network. Some plans require prior approval before you order the bed, so check before the supplier places an order.

Other ways to pay if Medicare does not cover it

If Medicare denies coverage and the appeal does not succeed, you can pay out of pocket for a rental or purchase. Some DME suppliers offer discounts to people paying without insurance, so ask about pricing before you decide.

Medicaid may cover a hospital bed if you are may be able to access for both Medicare and Medicaid (called "dual may be able to access"). Contact your state Medicaid office to ask. Some charitable organizations and disease-specific nonprofits also help pay for medical equipment — search online for organizations related to your condition.

If cost is a barrier, talk to your doctor about whether other solutions might help, such as bed rails, a mattress overlay to reduce pressure, or physical therapy to improve mobility. Sometimes a less expensive piece of equipment can solve the problem.

Questions to ask your doctor

Before your doctor writes an order, ask these questions to make sure you understand what Medicare will and will not cover:

Do you think a hospital bed is medically necessary for my condition, or are there other options that might help?
How long do you expect I will need the bed?
Will you write the order so that Medicare will understand why it is medically necessary?
Do you have a preferred DME supplier, or should I find one myself?
If Medicare denies the claim, will you provide additional medical information to support an appeal?

Frequently Asked Questions

Does Medicare cover mattresses or bed rails?

Medicare covers a hospital bed frame and mattress as one unit. Bed rails, mattress overlays, and other accessories are usually not covered separately, though some DME suppliers include them with the bed rental. Ask the supplier what is included in the monthly rental price before you agree.

What if I need the bed right away and do not have time to wait for approval?

You can rent a bed when ready and pay out of pocket, then submit the Medicare claim once your doctor's order is ready. Keep all receipts and the supplier's invoice. If Medicare approves the claim later, you may be reimbursed for the portion they cover, though this varies by supplier and situation. Ask the supplier whether they will handle the reimbursement or whether you will need to submit it yourself.

Can I use a hospital bed from a thrift store or buy one used?

Medicare will not cover a used bed or one from a non-Medicare supplier. You must rent or buy from a Medicare-enrolled DME supplier for Medicare to pay. Used beds are much cheaper out of pocket, but Medicare will not reimburse any part of the cost.

What if my doctor says I need a hospital bed but Medicare's reviewer disagrees?

This disagreement happens sometimes. You can appeal and have your doctor send medical records, test results, or a detailed letter explaining why the bed is necessary for your safety or medical condition. Many appeals succeed when the doctor provides clear documentation of the medical reason.

Do I have to use the same supplier Medicare approves, or can I switch?

You can use any Medicare-enrolled DME supplier. If you are unhappy with your current supplier's service or price, you can switch to another one. The new supplier will need a copy of your doctor's order and will bill Medicare directly, just like the first supplier did.

This guide is for general information only and is not medical, financial, legal, or other professional advice. For decisions specific to your situation, consult a qualified professional. See our Editorial Policy.