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When recovering from surgery or illness, your usual bed won’t always be enough. You may need the use of a hospital bed, which provides more support, security, and comfort. But with any major purchase, you’re left with the big question. How can I pay for this? Medicare can help, but you must have a qualifying diagnosis for a hospital bed.

For some items in this policy to be covered by Medicare, a written order prior to delivery (WOPD) is required. Refer to the DOCUMENTATION REQUIREMENTS section of this LCD and to the NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES section of the related Policy Article for information about WOPD prescription requirements.

Medicare will cover the hospital bed as long it’s medically necessary to help your condition. Your doctor will need to order the bed and show how it will help your condition.Medicare pays for all medical equipment, including hospital beds, under Medicare Part B. Part B will pay 80% of the cost of your hospital bed.You might be able to get more coverage if you have a Medigap or Medicare Advantage plan.When does Medicare cover hospital beds for home use?Hospital beds for home use are considered durable medical equipment (DME). Medicare covers DME under Part B. Your hospital bed will need to meet a few conditions in order to be covered.

For any item to be covered by Medicare, it must 1) be eligible for a defined Medicare benefit category, 2) be reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member, and 3) meet all other applicable Medicare statutory and regulatory requirements. For the items addressed in this medical policy, the criteria for “reasonable and necessary” are defined by the following indications and limitations of coverage and/or medical necessity.

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