The downside is that these mattresses can be expensive, so it’s worth knowing that Medicare will cover most of the cost for certain mattresses. Unsure what types of mattresses are covered by Medicare? We’ve done the research for you here…
What types of mattresses are covered by Medicare?
Medicare has certain guidelines that must be met before the cost of your mattress can be covered. For a start, the mattress needs to qualify as Durable Medical Equipment, or DME. DME is medically necessary equipment prescribed by a doctor to help patients function in their everyday lives. DME items can include crutches, walkers, blood sugar monitors and hospital beds. Certain mattresses are also included, but a doctor is the only person who can give a mattress this designation. To qualify, the mattress must meet the below conditions:
Be durable and able to withstand repeated useUsed for medical reasons onlyOnly useful to a sick or injured personFor use in a person’s homeHave an expected life expectancy of at least three years
Pressure-reducing mattresses, which are used for certain conditions such as sciatica and arthritis, are usually the only type of mattress covered by Medicare. Some of the top pressure-reducing mattresses that are approved by Medicare are outlined below:
What types of mattresses are not covered by Medicare?
While a number of mattresses will be covered by Medicare, many more mattresses won’t be. If the mattress you’re buying is for non-medical use and if it is not used for specific health care issues like sciatica and arthritis, you won’t be able to get any financial help from Medicare. Remember that Medicare will only cover the costs of mattresses that qualify for DME designation and meet the conditions mentioned above. If you can’t get Medicare to help pay for your mattress, browse this year’s Labor Day mattress sales for ways to keep some extra cash in your pocket.
How much of the mattress purchase will Medicare cover?
You will need to check your specific Medicare coverage to work out how much Medicare will pay and how much you will need to contribute. However, as mattresses are covered under Medicare Part B (opens in new tab), in most cases Medicare will cover 80% of the cost of your new mattress and you will need to pay for the remaining 20%. The deductible will also apply, which is $233 in 2022.
Who is eligible for a mattress covered by Medicare?
To be eligible for Medicare help, you will need to get a doctor’s recommendation stating that you have a medical condition that requires you to buy a pressure-reducing mattress to ease discomfort. The note will need to explain what condition you have and how the mattress could improve your health. Once you’ve received the doctor’s note you will need to submit it to Medicare for consideration. If Medicare approves the request and agrees that you’re eligible, you can go ahead and make your purchase. One further condition is that the mattress must be bought from a Medicare-approved mattress retailer. If it’s not, you won’t receive your funds. You can search for approved suppliers on the Medicare website (opens in new tab).
Types of mattresses covered by Medicare: Summary
To summarize, if your mattress meets the following three criteria, Medicare will cover the cost of up to 80% of the mattress price:
DME classificationMeets the five qualifying criteria mentioned abovePressure-reducing mattress
You must also have a note from your doctor explaining why you need the mattress, and you must purchase the mattress from a Medicare-approved supplier. If you do not qualify for financial help from Medicare, it is still possible to find an affordable mattress for your needs. As a first step, make sure you shop around and compare retail options carefully. It is also well worth checking out the latest mattress sales (opens in new tab). Read more:
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