Medicare-Covered Beds: What Qualifies and How to Get One

You’d think something as basic as a bed would be simple on Medicare, right? But the rules can twist you up faster than tangled bedsheets in the night. Beds aren’t all created equal when it comes to coverage, and if you’re hoping to get Medicare to pick up the bill for yours (or someone you love), you’ve got to play by their book. Not every comfy mattress or shiny adjustable frame makes the cut. There’s a strict checklist—and knowing it means the difference between full-on support and a surprise bill. If you want the inside scoop on what kind of beds Medicare might cover, and how you can actually get one approved, you’re in the right place.

What Beds Does Medicare Actually Cover?

When we’re talking about Medicare, "Medicare beds" means those that count as Durable Medical Equipment (DME). If a doctor says it’s medically necessary, and it fits their guidelines, Medicare Part B steps in to help. The classic hospital bed is the big one here. We’re talking beds that adjust up and down, or have head and foot sections that move separately. Standard twin beds, waterbeds, fancy memory foam frames, and those cushy adjustable base beds from late-night ads aren’t on the list. It’s got to be a hospital-type bed made for people with specific health needs—not for comfort but for medical necessity.

Let’s get specific. Medicare covers:

• Manual hospital beds – You crank to adjust the height/head/foot.
• Semi-electric hospital beds – Electric for head/foot, manual for height.
• Fully electric hospital beds – Everything runs with a button, but often requires extra documentation because the manual or semi-electric is usually enough.

Side rails, trapeze bars, and certain types of pressure-relieving mattresses can sometimes be included, too, but there’s always paperwork. If it’s just for comfort, forget it. If you or your loved one needs to sleep with the head elevated due to chronic pulmonary disease or finds it impossible to get in and out of bed without rails, a doctor can make the case. For something like a fancy Tempur-Pedic or Sleep Number with massage features? That’s strictly out-of-pocket territory.

Medicare’s coverage is well-defined, but it moves with evidence. For example: since 2021, the push has been on for home-based recovery—so expect doctors to be extra detailed in their notes when asking for an at-home hospital bed versus simply more pillows at night. If you have a rare condition or need something special, expect some back-and-forth with your supplier and Medicare.

If you like specifics, here’s what Medicare considers a "hospital bed":

• Height-adjustable frame, at least at head or foot
• Heavy, wheeled construction
• Designed for safety and medical access at home

Now, for those thinking it covers everything under the sun, here’s a quick reality check with the types that Medicare does not cover:

• Beds built only for comfort or convenience
• Specialty beds for sleep disorders (like CPAP beds)
• Luxury mattresses or heated beds
• Low beds for fall prevention, unless justified medically

Qualifying for a Medicare-Covered Bed: The Fine Print

So how exactly does the approval path work? First—you can’t just buy the bed, file a claim, and hope for a check in the post. Everything starts with that doctor’s order. You need a prescription (yes, for a bed) explaining why a standard home bed won’t cut it. The most accepted medical reasons are:

• Difficulty getting in/out of a standard bed
• Need to change positions often to reduce pain or pressure sores
• Specific conditions like CHF, pulmonary disease, or spinal issues
• Recovery from surgery or injury that limits your mobility

The doctor must document these needs in great detail. Medicare is picky—they want notes stating exactly how a hospital bed will help that a regular bed cannot. Think “needs elevated head to support heart failure breathing” or “needs frequent head/foot adjustments for wound care.” Vague statements like “needs better sleep” won’t fly.

You’ll also need to use a Medicare-approved Durable Medical Equipment supplier. Many get tripped up here. If you buy from an online retailer or big box brand that isn’t enrolled in Medicare, you’re out of luck. Use Medicare’s website or ask your doctor’s office for approved suppliers. If you’re part of a Medicare Advantage Plan, check with your specific provider—sometimes their network rules are even stricter.

Here’s the fine print tip: Coverage isn’t usually full. Medicare Part B covers 80% of the allowed amount after you pay your yearly deductible. You’re on the hook for the other 20% unless extra insurance picks it up. And there’s no “free trial”—if you want to switch out for a fancier model, that’s up to you and your bank account.

Sometimes, beds are rented first, especially if you’re expected to recover in weeks or a few months. If you prove it’s a long-term need, you can eventually own the bed, but it’s common for beds to be rented for the first 13 months. Here’s a quick snapshot in a table:

The Step-by-Step Process to Get a Medicare Bed

Confused by the process? Here’s what needs to happen, step by step:

1. Schedule a face-to-face visit with your doctor. Discuss your sleep problems or mobility concerns in detail.
2. Your doctor writes a prescription and documents your medical need for a hospital bed.
3. You or the doctor send that prescription to a Medicare-approved DME supplier. They may have their own forms to fill out, so don’t be surprised by a bit of paperwork.
4. The supplier checks with Medicare (or your Advantage plan, if that’s what you have) to confirm coverage and any extra criteria based on your condition.
5. The bed is usually delivered to your home, assembled and adjusted for safety. If you’re renting at first, check when and how you transition to ownership if your condition is long-term.
6. You pay your share (20%, unless other coverage steps in), and any deductible if not paid for the year yet.

Sometimes the supplier or Medicare may ask for more details from your doctor. Stay in touch with both, and don’t be shy about calling the supplier if you have questions. If you’ve been hospitalized, social workers or discharge planners often help with this process, but at home you may be more on your own. Don’t sign for anything you didn’t order—if a supplier tries to push extras you don’t need, ask if it’s covered or say no.

If you need modifications—like bariatric beds for heavier users, or beds with special rails for safety—get that in your doctor’s notes up front. Once a claim is denied, it’s way harder to fix.

Pro tip: Always keep a copy of your prescription and paperwork. If you move, change your Medicare number, or need replacement parts, this will save you hours.

What’s Not Covered (and Why People Get Rejected)

You’d be surprised how many people assume Medicare covers anything that looks like a medical bed. Here’s where most folks get tripped up:

• Trying to get beds for "comfort only"—if there’s no clear medical reason, the claim will be denied.
• Ordering from non-approved suppliers—if they aren’t on Medicare’s list, forget about reimbursement.
• Requests for upgrades—Medicare covers what’s necessary, not what’s fancy. If you want all-electric with built-in massagers, expect to pay the full amount.
• Lack of documentation—vague doctor’s notes like “trouble sleeping” aren’t enough. The need has to be spelled out in detail.
• Applying for special mattresses without a documented risk of bedsores. Pressure-relief mattresses can be covered, but only if there’s a proven risk or a bedsore diagnosis in the records.

If your claim is denied, you can appeal—but it’s a slow road. Most of the time, denials are because the paperwork was too vague, the doctor forgot to mention why a regular bed wouldn’t work, or because you tried to buy a bed before getting it approved. Timing and details matter. Always start with your doctor, not the supplier, to avoid heartbreak.

Tips and Extra Advice: Making Medicare Work for You

The best advice? Get the doctor involved early and don’t skimp on the medical details. If your mobility is changing, keep your needs updated at each appointment. Don’t feel odd about asking for a hospital bed: if you’re struggling to breathe fully flat, getting constant sores, or worried about falling out of a normal bed, Medicare’s program is there to help. It’s not charity—it’s part of your benefits.

Consider your living situation. If you have steps at home, will the bed fit where you need it? Will it block doors? If the room is small, ask about beds that break down or tuck away. Suppliers can measure space for you, so don’t just assume “hospital bed” means it’ll fit where a normal bed did.

If you have a Medicare Advantage plan, your path could be even trickier. Some plans need pre-authorization, and suppliers are sometimes more limited. Don’t order before confirming coverage—you could be hit with hundreds in charges for a mistake.

Double-check every delivery. “Upcoding,” or giving you a more expensive model without medical need (and billing you for it), does happen. If the bed delivered doesn’t match your prescription, call the supplier and your doctor immediately. And store every single piece of paper. Medicare audits happen—in 2023 alone, more than 10,000 DME claims were checked for fraud or upcoding issues.

If you need help, reach out to your local council or the Age UK advice line. They know the Medicare ropes and have seen it all. Ask if you’ll need any adaptions for hoists, wheelchairs, or home carers.

Also, don’t ignore maintenance. If something breaks, repairs may be covered as part of Medicare DME if it was a rental or purchased via Medicare. Don’t just buy parts online or get a neighbor to fix it—it could void coverage or create safety issues. Stick with approved repair shops for hospital beds.

In summary: getting a Medicare-covered hospital bed really does require jumping through some hoops, but the peace of mind (and a good night’s sleep) is worth it. Just remember: document, double-check, and ask for help if you’re stuck. Sleep tight, paperwork warriors.