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For many, the main purpose of a mattress is to help you get a good, comfortable night’s sleep. For others, however, a mattress may serve a medical purpose. One example of this is a pressure reducing mattress that helps relieve pain.
If you’re looking for a new mattress, a common question many people have is, “Does Medicare cover Mattresses?” In this article, we answer this question in clear, plain English. You will also find the average costs of mattresses, as well as other helpful info.
The short answer is it depends; Medicare may cover the cost of a mattress. But not 100% of the time. As is often the case with Medicare, certain conditions have to be met in order for Medicare to pay for your mattresses. Below we look at what these are so you know what to expect.
Original Medicare (Medicare Part A and Part B) provides coverage for the costs of mattresses. However, they will not cover mattresses that you get just for comfort.
There has to be a medical need for the mattress in order for Medicare to cover it. In this case, Medicare can provide coverage for certain types of mattresses. One type they may cover is a pressure-reducing mattress.
Pressure-reducing mattresses are considered durable medical equipment (DME), which Medicare Part B covers. Adjustable beds can also qualify as DME and get coverage from Medicare as well.
In order to get coverage, however, your healthcare provider must decide that the mattress is medically necessary. Also, both your healthcare provider and the DME supplier have to be Medicare-approved. If they are not, Medicare may not reimburse you for the costs of the mattress.
But, if you meet all the requirements above, then Medicare Part B will provide coverage for the purchase or rental of pressure-reducing mattresses.
Medicare Part B will cover 80% of the costs of purchasing or renting a pressure-reducing mattress. The remaining 20% will be paid by you.
Medicare Advantage plans (Medicare Part C) also provide coverage for pressure-reducing mattresses as they cover everything Original Medicare covers. However, out-of-pocket costs will vary depending on the plan provided by the plan providers.
Check with your plan provider to get the specifics for your plan.
Pressure-reducing mattresses cost around $350 on the low end and can go up to $3,000. Most adjustable mattresses cost between $1,000 and $3,000. Costs largely depend on the size of the bed and what features it has.
Note: Medicare coverage changes all the time. And your specific coverage may vary from plan to plan for Medicare Advantage and Medigap plans. Always be sure to double check with your health care provider and/or Medicare insurance provider about what your plan covers and what it does not.
This article is part of our series on “What does Medicare cover?”
Also, you can check out other articles in this series including: Does Medicare cover Stem Cell Therapy For COPD?