What exactly is a lift chair?
A lift chair is an electric motorized recliner chair, typically operated with a few buttons on a controller. The chair hoists a limited mobility person from sitting to standing. It also works in reverse, helping someone go from standing to sitting without falling into the cushions.
How does Medicare cover lift chairs?
First, your doctor must fill out a form that declares a lift chair medically necessary for your treatment. Medically necessary in this case is a complicated way of saying you need it, a doctor can vouch for that need, and the equipment meets Medicare’s standards.
When you see your doctor, they will need to fill out a certificate of medical necessity (CMS-849) and then submit it to Medicare (or your Medicare Advantage provider).
To determine if your mobility is limited enough to qualify a lift chair as medically necessary, your doctor will need to answer the following questions on the form:
- “Does the patient have severe arthritis of the hip or knee?”
- “Does the patient have a severe neuromuscular disease?”
- “Is the patient completely incapable of standing up from a regular armchair or any chair in his/her home?”
- “Once standing, does the patient have the ability to ambulate?”
- “Have all appropriate therapeutic modalities to enable the patient to transfer from a chair to a standing position (e.g., medication, physical therapy) been tried and failed? If YES, this is documented in the patient’s medical records.”1
(Not all of these questions must be answered in the affirmative for you to receive lift chair approval.)
If you receive approval, Medicare covers up to 80% of the cost of the machine that lifts the chair. However, the cushions and framework of the chair itself aren’t covered. The motor and gear required to lift the chair are covered.2
Are there situations where I may be denied coverage for a lift chair?
Even if you qualify based on the questions above, Medicare may still deny you a lift chair if it has already covered the following items for you:
- A manual wheelchair
- A power wheelchair
- A mobility scooter
However, even if Medicare has covered one of these items for you, as long as your health has improved to the point that you can walk again, you might also receive Medicare coverage for a lift chair.
Additionally, if you are currently in a hospital or skilled nursing facility, Medicare coverage for a lift chair is more likely to be denied.
Looking for Medicare coverage?
Are you unhappy with your current Medicare coverage? Medicare Advantage may be a good alternative. Or if you like Original Medicare, you could supplement your coverage with a Medicare Supplement (Medigap) plan to help cover costs that Medicare doesn’t.
To find a plan that may work better for you, call an experienced agent today.
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1. Centers for Medicare and Medicaid Services, “CMS-849—Seat Lift Mechanisms”
2. Pride Mobility, “Consumer Guide to Medicare Coverage for Lift Chairs”
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