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Three Steps to Medicare Coverage for your Lift Chair

 

Medicare will tell you that they cover a lift chair.  That is not the whole story.  They do not cover the furniture portion of the lift chair.  They only cover the motorized lift mechanism inside the chair.

Do you qualify?  Just because the lift mechanism is a Medicare covered item does not mean every member can get this coverage.  You must meet certain criteria and have the proper documentation.

But do not worry.  With some planning you can navigate the steps to getting a Medicare reimbursement for the lift mechanism inside your chair.  How much is the reimbursement?  Medicare sets the rates four times per year.  At the time of this writing, the reimbursement rate is $282.

In general, you may qualify for the lift mechanism coverage if you need a lift chair to stand you up inside your home.  After you are standing, you must be able to walk.  In other words, you cannot get a lift chair to go from a chair to a wheelchair.  The whole purpose of the lift chair is to get you into a standing position.  Therefore, standing must be part of the plan.

Step 1:  the prescription

 

The first step to getting the lift mechanism covered is to schedule a face-to-face visit with your treating physician.  As of today, this visit can be a telehealth visit.  When the pandemic is over, they may require in-person visits again.  We will have to wait and see.

Your doctor will determine if you need a lift chair.  If they think you do, then they will send a prescription for a lift chair to the provider.  In this case, the provider is Charron Medical Equipment.  Our office and showroom are in Nashua, New Hampshire, and most area doctors already know us.  But just in case, take this fax number with you when you have your face-to-face:  603-889-6221.

Step 2:  do you qualify

 

The Certificate of Medical Necessity (CMN) form is required too.  Take this form with you to the face-to-face or have your provider (Charron Medical) fax it over to the doctor’s office.  The physician must complete the form fully, and that is what determines your eligibility for the lift mechanism through Medicare.

The form will ask these questions:

  1. Does the patient have severe arthritis of the hip or knee?
  2. Does the patient have a severe neuromuscular disease?

(you must have at least one of these two to qualify)

  1. Is the patient completely incapable of standing up from a regular armchair or any chair in his/her home?
  2. Once standing, does the patient have the ability to ambulate?

(you must be able to walk with or without the help of a cane/walker)

  1. Have all appropriate therapeutic modalities to enable the patient to transfer from a chair to a standing position been tried and failed?

(this must be documented in the patient record)

 

Medicare will not cover the lift chair mechanism if you are in the hospital or skilled nursing facility.  This falls under their Coordination of Benefits billing policy.  Therefore, be sure to wait until you are home before ordering your chair.

 

Medicare will also not cover the lift chair mechanism if you are already renting a wheelchair through Medicare.  Because you must be able to walk for the lift chair coverage, you cannot already be in a wheelchair.

 

Step 3:  shopping for your lift chair

 

This is the fun part.  Stop by Charron Medical on Main Street in tax-free Nashua, New Hampshire.  Pick out a chair that suits you and your living room.  We have many styles and sizes, including Pride and Golden Lift Chairs.  There are multiple features to consider.  Try out the different chairs to make sure you are happy with the fit, comfort and features.

After you have paid for your chair and we deliver it to your home (local delivery included), we will submit the claim to Medicare.  If all goes well, they will send you a reimbursement check within 30-60 days.  If you do not qualify for a medicare lift mechanism, you may still purchase the chair.  A power recliner or seat lift chair is an investment in your health and well-being.  It can be a beautiful piece of furniture too, matching your lifestyle and decor.

Stop by today to see the lift chairs we have in our showroom.  You can download the lift guide by clicking here.