If you or someone in your family is struggling to get up from a seated position due to a medical condition, a lift chair can make a huge difference in daily life and safety. But before committing to a purchase, most people have one big question. Will Medicare pay for a lift chair?
The short answer is yes, but only partially and only under specific conditions. In this post we break down exactly what Medicare covers, what you need to qualify, and how to get the process started without the headache.
What Medicare Actually Covers
Medicare Part B covers the lift mechanism of a power lift chair, you can read the official coverage details on Medicare.gov. That’s the motor that raises and tilts the chair forward to help you stand. Medicare does not cover the recliner part of the chair, the cushioning, the fabric, the frame. Just the motor.
In practice, what this means is that Medicare will pay 80% of the approved amount for the lift mechanism. You pay the other 20%, plus your Part B deductible if you haven’t met it yet. Your secondary insurance may cover that 20% depending on your plan.
The amount Medicare approves for the lift mechanism is set by Medicare, it’s not the same as the full price of the chair. A good lift chair recliner might cost $900 to $2,500 depending on the model. Medicare’s approved amount for the mechanism alone is typically in the $300 to $400 range. So you’ll still have some out-of-pocket cost, but it helps.
You Need a Doctor’s Prescription First
This is the part people miss. Medicare won’t cover anything without a written prescription from your doctor. The prescription needs to say that you have a medical condition that makes it hard or unsafe to stand up from a seated position on your own. Things like severe arthritis, Parkinson’s disease, muscle weakness, or recovery from hip or knee replacement surgery usually qualify.
The prescription also needs to come from a doctor who has examined you, not just a note over the phone. Medicare is pretty strict about this. If the paperwork isn’t done right, the claim gets denied.
You Also Need a Medicare-Approved Supplier
This is the other piece people don’t always know. Even if you have a valid prescription, you have to buy the lift chair recliner from a Medicare-approved DME supplier. If you buy from a store that isn’t enrolled with Medicare, you pay the full price out of pocket and there’s no reimbursement.
Reliable DME Pro is a Medicare-approved DME supplier in Downers Grove, IL. We handle the prior authorization, submit the claim to Medicare on your behalf, and bill your insurance directly. You don’t have to deal with any of that paperwork yourself.
Which Lift Chair Recliners Qualify?
Not every lift chair qualifies. Medicare covers power lift chair recliners the ones with an electric motor that raises the seat. Manual recliners that you push back yourself don’t qualify, even if they have some kind of lift-assist mechanism.
We carry Golden Technologies lift chair recliners and Pride VivaLift models, both are Medicare-eligible when prescribed. Models like the Golden MaxiComfort Cloud, Golden Cloud series, Golden Titan, Pride VivaLift Ultra, and Pride VivaLift Radiance all qualify. We’ll confirm the specific model is covered before we place any order.
If you’re not ready to buy, we also offer lift recliner rentals a good way to try one at home during recovery before committing to a purchase.
What About Medicaid?
Illinois Medicaid also covers lift chair recliners in some cases, but the approval process is different from Medicare. Coverage depends on your specific Medicaid plan and whether a prior authorization is approved. We work with Medicaid patients regularly and know how to navigate the process. Call us and we’ll check your specific coverage before anything else.
What If Medicare Denies It?
It happens sometimes. Usually it’s because the documentation from the doctor wasn’t detailed enough about the medical necessity. We’ve seen claims get approved on resubmission after the physician adds more specific language about the patient’s condition and limitations.
If your claim is denied, don’t just give up. Talk to your doctor about the denial and ask if they can provide more detailed notes. We can also help you understand what the denial reason was and what might fix it.
How to Get Started
If you’re in Illinois and thinking about a lift chair recliner, here’s what to do:
Talk to your doctor at your next visit. Tell them you’re having trouble standing from a seated position and ask if they’d write a prescription for a power lift chair recliner. If they agree there’s a medical need, they write the prescription.
Give us a call at (630) 929-0745, you can also reach us at (773) 555-0147. We’ll verify your Medicare benefits, walk you through the chair options that qualify, and handle everything from there. You come to our Downers Grove showroom to pick the model you like, or we can describe the options over the phone if getting here is difficult.
Most people are surprised at how straightforward the process is once they have the prescription in hand.
If you have questions before any of that, just call. We answer the phone and we’ll give you a straight answer about what your coverage looks like. No pressure, no runaround.