Lift chairs play an important role for seniors aging in place, people with limited mobility, or individuals recovering from surgery. MedMart’s showroom has a large selection to try out for comfort; however, knowing what Medicare or other insurance covers can be challenging.
Medicare Coverage
Original Medicare Part B may cover the seat-lift mechanism of a lift chair when specific medical-necessity requirements are met. It does not cover the cost of the chair itself.
After meeting the annual Part B deductible, Medicare generally pays 80% of the Medicare-approved amount for covered Part B services and equipment, while the beneficiary is responsible for the remaining 20%.
What Medicare Actually Covers and What It Doesn't
Here are a few common situations that come up once a lift chair is already in one’s home.
The Seat Lift Mechanism Itself
Medicare Part B treats every motorized lift mechanism as durable medical equipment, rather than the overall chair. This is just a part of a lift chair that Medicare agrees to pay for.
What counts as the covered mechanism
- The motor that raises the seat
- The controls that operate it
- Nothing related to comfort or style
- Installation as part of the device
Other things about the chair, including the fabric and the footrest, are treated as ordinary furniture and billed separately when ordering medical mobility equipment or other medical supplies.
Repairs to an Existing Lift Chair
Once you’ve already added a lift chair in your home, Medicare will likely not pay for repairs.
Why repairs usually fall outside coverage
- Repairs are never classified as new equipment
- No standard billing code will cover general repairs
- Warranty terms apply instead
- Out-of-pocket expenses are typically common
Med Mart Home’s dedicated team for home mobility equipment repairs can handle this type of work on an ongoing basis. The experts can also fix lift chairs, patient lifts, and hospital beds on an urgent basis if needed.
Replacing a Worn-Out or Broken Chair
Replacement of a lift chair follows entirely different rules than repairs. Medicare might consider a new lift mechanism if the original is beyond repair and medical necessity still applies.
What Medicare reviews before approving a replacement
- A new certificate of medical necessity
- Confirming the original was Medicare-covered
- Purchasing through an approved supplier
Medical Necessity Documentation
A doctor needs to formally certify that a lift chair is a medical necessity before Medicare will consider any part of the cost. This applies to the real purchase and to any future replacement requests.
What the documentation needs to show
- A medical screening for conditions such as arthritis or neuromuscular diseases
- Inability to stand up from a regular chair
- Ability to walk once standing
- The chair will only be used at home
Medicare will refuse to pay without this paperwork, and it doesn’t cover a lift chair regardless of how clearly the device is needed.
Medicare Advantage Plans and Lift Chairs
Medicare Advantage plans follow the same guidelines as Medicare, but plan networks, authorization requirements, cost-sharing, and additional benefits can vary.
What can differ between plans?
- Suppliers who are considered in-network
- Whether any additional features are covered
- Copay amounts instead of standard coinsurance
- Earlier authorization needs before any purchases
Reviewing the exact plan with the help of experts before shopping is the most effective way to know what’s really included.
What You'll Likely Pay Out of Pocket
Even with approval, a lift chair will have out-of-pocket costs for the member; Medicare will not cover the entire chair, only the mechanism. Knowing this upfront can help you budget for the purchase and save frustration.
Costs that typically fall on the buyer
- Upholstery and frame of the chair
- Costs related to equipment delivery and installation
- future repairs
- Any additional features besides basic lifting
Planning for these costs early can help the process feel less like a series of unexpected expenses that may arise later.
How Med Mart Home Supports You From Start to Finish
Finding the right lift chair and knowing who to call if something goes wrong later matters just as much as understanding what Medicare will or won’t pay for. Med Mart Home is a full-service medical equipment and home modification provider.
If you would like to file a claim on the lift mechanism, the process starts with a prescription from your physician. Chair selection is the enjoyable part! Stop by MedMart’s showroom and try a variety of lift chairs to find the right fit for you.
From that very first call to any repair down the road, you’re never left figuring things out alone. Contact us today to talk through your lift chair or repair needs and get started.
Getting the Right Support Doesn't Have to Be Complicated
Whether you’re starting to look into purchasing a lift chair or navigating a repair on one purchased in the past, MedMart is here for you.
Frequently Asked Questions
Can I get a lift chair through Medicare without a doctor's approval?
No, Medicare requires a written certification of medical necessity before covering any part of a lift chair.
Does Medicare cover lift chairs for people in a nursing home?
No, lift chair coverage applies only to chairs used in a person’s home, not in a nursing home or hospice setting.
How long does Medicare approval for a lift chair usually take?
The timeline can vary depending on the documentation, supplier, and whether additional information is required.
Will homeowners or renters insurance help cover a lift chair?
No, since insurance usually covers accidental damage rather than planned medical equipment purchases.
Can I appeal if Medicare denies coverage for a lift chair?
Yes. If Medicare denies a claim, you generally have the right to appeal. The Medicare Summary Notice or denial notice will explain the reason for the decision and how to start the appeal.
