Does Medicare Cover a Hospital Bed for Home Use

What Medicare covers for a hospital bed at home

Medicare Part B covers a hospital bed for home use 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 it has to treat or manage a condition you have. Medicare will pay 80 percent of the approved amount after you meet your Part B deductible. You pay the remaining 20 percent.

The bed itself is classified as durable medical equipment (DME). Medicare does not pay for the bed outright; instead, it pays a rental fee to a DME supplier. Most people rent rather than buy, and the rental typically costs less than purchasing. If you rent for long enough, the total rental payments may reach the purchase price, at which point the supplier owns it — you do not automatically own it after a certain time.

Your doctor's order is the first requirement. Without it, Medicare will deny the claim. The order must state why you need the bed — for example, "patient requires head elevation due to COPD" or "patient needs bed rails for safety due to fall risk." A general statement that you need a hospital bed is not enough.

Key Takeaways

Your doctor must write a specific order stating the medical reason you need a hospital bed; Medicare will not cover it without this order.
Medicare pays 80 percent of the approved rental amount after your Part B deductible is met, and you pay 20 percent.
You must use a Medicare-approved DME supplier; using an unapproved supplier means Medicare will not pay anything.
The supplier handles the paperwork and sends it to Medicare; you do not submit the claim yourself.
If you have a Medigap or Medicare Advantage plan, your coverage for the 20 percent coinsurance may differ.

How to get your doctor's order

Start by talking to the doctor who is treating the condition that requires the bed. This is usually your primary care doctor, but it could be a specialist — a pulmonologist if you have lung disease, a cardiologist if you have heart failure, or a neurologist if you have a neurological condition. Tell them you are having trouble sleeping or moving in a regular bed, or that your condition requires you to keep your head elevated or your legs raised.

The doctor will examine you and decide whether a hospital bed is medically necessary. If they agree, they will write an order. The order goes to a DME supplier, not to Medicare directly. You can ask your doctor which suppliers they work with, or you can find one yourself and give the doctor's contact information to the supplier so they can request the order.

If your doctor is unsure whether to write an order, ask them to document in your medical record why a hospital bed would help your condition. This creates a paper trail that supports the medical necessity if Medicare questions it later.

Finding and working with a Medicare-approved DME supplier

Not every medical equipment company is approved by Medicare. You must use a supplier on the Medicare DME supplier list. You can search for suppliers in your area on the Centers for Medicare & Medicaid Services (CMS) website at dmepos.cms.gov. Enter your ZIP code and the type of equipment (hospital bed) to see which suppliers are approved near you.

Call the supplier and tell them you have a doctor's order for a hospital bed. They will ask for your Medicare number, your doctor's name and contact information, and the reason your doctor says you need the bed. The supplier then contacts your doctor to get a copy of the order. Do not give the order to the supplier yourself — they must request it directly from the doctor's office.

Once the supplier has the order, they will submit it to Medicare for prior authorization. This step is crucial: Medicare must approve the order before the bed is delivered. The supplier should tell you whether approval came through before they deliver anything. If Medicare denies the order, the supplier will tell you why, and you can work with your doctor to provide more information or appeal the decision.

What happens after Medicare approves the order

Once Medicare approves the order, the supplier will deliver the bed to your home. They will set it up, show you how to use it, and explain the rental terms. You will receive a bill from the supplier for your 20 percent coinsurance. The supplier bills Medicare for the 80 percent.

Rental payments are usually monthly. The supplier will continue to bill you and Medicare each month as long as you are using the bed. If you no longer need the bed, tell the supplier and your doctor. The supplier will pick it up, and the rental payments will stop.

Keep records of all bills and payments. If you have questions about what Medicare paid or what you owe, you can call Medicare at 1-800-MEDICARE and give them your claim number.

When Medicare denies a hospital bed request

Medicare may deny your request if your doctor's order does not clearly state a medical reason, if the reason given is not considered medically necessary by Medicare standards, or if your medical record does not support the need. Common reasons for denial include "patient wants a more comfortable bed" or "patient is elderly and might fall" — these are not medical reasons Medicare recognizes.

If Medicare denies the order, the supplier will send you a notice called an Explanation of Benefits (EOB). This notice explains why Medicare said no. You have the right to appeal. You can ask your doctor to provide more detailed medical information, or you can submit additional documentation from your medical record that shows why the bed is necessary.

To appeal, follow the instructions on the EOB. You usually have 120 days from the date of the denial to file an appeal. The supplier can help you with this process, or you can contact Medicare directly.

Hospital beds and supplemental insurance

If you have a Medigap policy, it may cover part or all of your 20 percent coinsurance for the hospital bed. Check your policy documents or call your Medigap insurer to ask what they cover for DME.

If you have a Medicare Advantage plan, the rules are different. Your plan may cover hospital beds with little or no coinsurance, or it may have different approval requirements. Contact your plan before you ask your doctor for an order, because some Advantage plans require you to use specific suppliers or get prior authorization from the plan instead of from Medicare.

If you are on Medicaid in addition to Medicare, Medicaid may cover costs that Medicare does not. Contact your state Medicaid office to ask about coverage for hospital beds.

Alternatives if Medicare denies coverage

If Medicare denies your request and you cannot appeal successfully, you have other options. You can purchase a hospital bed out of pocket — prices range widely depending on the type and features, but basic models are often less expensive than several months of rental. You can also rent from a non-Medicare supplier, though you will pay the full cost yourself.

Some community organizations, charities, and churches loan or donate medical equipment, including hospital beds. Contact your local Area Agency on Aging to ask whether any programs in your area offer free or low-cost equipment. You can find your local agency at eldercare.acl.gov.

If cost is the barrier, ask your doctor whether a different solution might work — for example, a bed wedge or adjustable mattress instead of a full hospital bed, or a bed rail that attaches to a regular bed. These items may have different Medicare coverage rules.

Frequently Asked Questions

Can I buy a hospital bed instead of renting one from Medicare?

Yes, but Medicare will not pay for it. If you buy a bed, you pay the full cost yourself. If you rent through a Medicare-approved supplier, Medicare pays 80 percent. Buying makes sense only if you need the bed for a short time or if you cannot find an approved supplier in your area.

What if my doctor says I need a hospital bed but Medicare says I do not?

Medicare has specific medical criteria for what counts as medically necessary. Your doctor's opinion matters, but it is not the final word. If Medicare denies the order, ask your doctor to write a more detailed explanation of your medical condition and why the bed is necessary. You can then appeal Medicare's decision with this additional information.

Do I have to rent from the supplier Medicare chooses?

No. You can choose any Medicare-approved supplier in your area. Medicare does not assign you to a supplier. Search the DME supplier list and pick the one that works best for you. The supplier must be approved, but you have the choice.

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

You can rent a bed from a non-Medicare supplier right away and pay out of pocket. Once Medicare approves your order, you can switch to a Medicare-approved supplier and Medicare will start paying. Keep your receipts from the non-approved supplier in case you want to ask Medicare to reimburse you, though reimbursement is not may provide.

Will Medicare pay for a new mattress or rails for the hospital bed?

Medicare covers certain accessories as part of the hospital bed rental — usually a basic mattress and basic rails are included in the rental fee. Specialty mattresses (like pressure-relief mattresses) may be covered separately if your doctor orders them for a specific medical reason. Ask the supplier what is included in the rental and what costs extra.

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.