Details on Medicare coverage of power

Dear Savvy Senior: Because of back pain and knee arthritis, I’m interested in getting a power-­lift recliner for my living room that’s easy for me to get into and out of. Does Medicare cover them? — Can’t Get Up

Dear Can’t: Yes, Medicare does indeed provide some coverage for lift chairs, provided your doctor prescribes it for a medical reason, but they won’t cover the entire cost of the chair. Medicare will pay only for the motorized lifting mechanism, which is considered durable medical equipment and is covered under Part B. The other parts of the chair — the frame, cushioning, and upholstery — are not covered. Here are a few more details you should know.

What is a lift chair?

First, for those who aren’t familiar with them, lift chairs, which look like traditional recliners, have motorized lift mechanisms built in that aid with standing up and sitting down for people with limited mobility. With the push of a button, a lift chair hoists a person from sitting to a position where they can comfortably stand up. It also works in reverse to help a person gently take a sitting position.

Coverage requirements

If you’re a Medicare beneficiary, you can find out whether you qualify for coverage by first getting a prescription and a “Certificate of Medical Necessity” from your doctor that indicates your need for a lift chair. The conditions you’ll need to meet include:

>> That you have severe arthritis of the hip or knee, or a severe neuromuscular disease.

>> That you can’t stand up on your own from a regular chair.

>> Once standing, you can walk independently or with the aid of a walker or cane.

>> That you do not reside within a skilled nursing facility, hospice or nursing home facility.

You’ll also need to purchase your lift chair from an equipment supplier that’s enrolled in Medicare. To find and compare Medicare- approved suppliers in your area, go to Medicare.gov/medical-equipment-suppliers, then type in your ZIP code and “Seat Lift Mechanisms” in the equipment box.

If you do qualify, Medicare will pay 80% of the approved cost of the chair’s motorized lifting mechanism, after you’ve met your Part B annual deductible. You or your Medigap supplemental policy (if you have one) will pay the remaining 20% of the lift mechanism. You will also pay 100% of the remaining cost of the chair.

You should also be aware that if you do buy your lift chair from a Medicare supplier, you will likely pay for the total cost of the chair upfront and can then seek reimbursement from Medicare.

Lift chairs can run anywhere from $400 to $2,000 or more depending on the fabric, options and upgrades. The reimbursement is usually between $250 and $300, depending on the state you live in.

Helpful options

If you happen to get your Medicare benefits through a private Medicare Advantage plan, they too provide lift-chair coverage, but they might impose different rules and will likely require you to see an in-network supplier. You’ll need to contact your plan directly for details.

If you find that Medicare won’t cover your lift chair, or if you’re looking for something less expensive, there are assistive products you can add to your current furniture. The Stander EZ Stand-N-Go (Stander.com, $140), for instance, has adjustable support handles that can be used on any sofa or recliner to help with sitting down and standing up.

Another way to make your furniture more accessible is by increasing its height with “furniture risers.” These typically range from 2 to 5 inches in height and are inserted under the legs of your furniture. Costs range from a few dollars to $50 or more, and they can be purchased at retail stores such as Walmart and Target, or online at Amazon.com.

Jim Miller is a contributor to NBC-TV’s “Today” program and author of “The Savvy Senior.” Send your questions to Savvy Senior, P.O. Box 5443, Norman, OK 73070; or visit savvysenior.org.

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