How To Get A Hospital Bed Through Medicaid

If something happens to you that requires you to be confined or positioned your body in a way that cannot be achieved using your home standard bed, you might be searching for ways on how you could get hospital bed with a discount or for free. Fortunately, if you have insurance such as Medicaid, you can get a hospital bed; however, you need to follow these steps on how you can get it.

In order for you to get a hospital bed through Medicaid, first, you need to get a doctor’s order by examining your overall health status for the medical equipment you need.  Your doctor must complete and submit all the necessary paperwork that proved you really qualify to get a hospital bed.

Basically, Medicaid will cover Durable Medical Equipment (DME)  such as hospital beds UNLESS you meet certain conditions, which will be further elaborated later on. Hence, to give you the guide on how to get a hospital via Medicaid, you can read more on this topic below.

 Steps On How To Get A Hospital Bed Using Medicaid

Getting a hospital bed through Medicaid is not as easy as ABCs. There are several things to consider before you will be qualified to get a hospital bed. In order for you to be eligible, prior authorization requests for all covered hospital beds must meet the basic requirements such as:

  • If your body requires positioning in ways that are not feasible with an ordinary bed due to your medical condition and is expected to last for at least 30 days
  • You need a head elevation of more than 30 degrees due to congestive heart failure, chronic pulmonary disease, and other health conditions concerning with aspiration. Moreover, you tried all the possible ways, which include the use of pillows and wedges yet it failed.
  • Your medical condition requires special attachments such as footboard, trapeze, or traction equipment that cannot be used in an ordinary bed.

Once you have met these conditions, your insurance company will approve your request. However, specific criteria may apply for each hospital bed type. You can learn more about this by checking this site.

Generally, here is a summary of how to get a hospital bed through Medicaid.

First, you need to talk to your primary care physician so that he/she can assess and examine your health status. After you have been examined by your doctor, he/she must issue an order or prescription stating that you really need a hospital bed based on the above conditions. Your doctor must completely fill-up the form and submit paperwork.

Once you received the prescription, call your insurance company whether they have their own suppliers as this can make the claiming process simple and easy. If not check your provider for medical equipment if they accept Medicaid (here is an example of a medical equipment supplier that accepts Medicaid). Another thing is that if the medical equipment supplier meets certain requirements. This will be more elaborated later on.

Finally, you already know the steps on how to get a hospital bed through Medicaid. You might be wondering what other medical equipments are covered by Medicaid aside from hospital beds so that just in case you need one, you may know if that medical equipment is included in the coverage.

Hence, here is a table that will show you the list of medical equipment covered by Medicaid.

What Other Medical Equipment Are Covered By Medicaid?

Aside from hospital beds, there is a lot of medical equipment being covered by Medicaid. Here is a table that will show you per category.

DURABLE MEDICAL EQUIPMENTEXAMPLES
Mobility aidsCanes, crutches, scooters, walkers, wheelchairs
Personal care needsBath chairs, commodes, dressing aids
Bedding materialsBili lights, blankets, hospital beds, lift beds, pressure mattress
ProsthesesDentures, eyeglasses, hearing aids, pacemakers, orthopedic shoes, arm slings
OrthoticsAnkle Foot Orthosis (AFO), Cervical brace, dynamic splint
Oxygen supplies and nebulizersVentilators, oxygen monitors, oxygen concentrators
Traction equipment 
Kidney devices, urological and ostomy supplies 

 These are some of the durable medical equipment covered by Medicaid. You can check this site to see the full list of durable medical equipment and coverage policies of Medicaid.

Well, speaking of coverage policies, you must also know the coverage limitations for medical equipment since there are certain things you need to do, in order to make sure that Medicaid will cover or reimburse the fees for this medical equipment.

What Are The Coverage Limitations Of Medical Equipment By Medicaid?

It does not mean that when you have an insurance policy, it will cover all the medical equipment without even meeting the requirements given; thus, you must make sure that your insurance company will shoulder the bill by knowing the coverage limitation ahead so that you can prepare what to do.

1. No Prescription Or Doctor’s Order

As a rule of thumb, Medicaid will not cover anything UNLESS you will present a prescription issued by your doctor that shows you really need the medical equipment. The doctor’s order or the prescription must include the following important information:

  • Date of the prescription
  • Signature of the doctor
  • Doctor’s license number

Aside from your doctor, here are other qualified personnel that can issue you a prescription for your needed medical equipment:

  • Physician’s assistant
  • Podiatrist
  • Advanced registered nurse

In some other cases, wherein, for example, you are staying in a home health agency, the process might be a bit different, yet almost the same principle. For you to qualify for durable medical equipment, you must talk to your agency so that they can create a plan of care. Once you have prepared the plan of care; have it signed to any of the following qualified personnel mentioned above.

2. Specific Providers

Another limitation of the coverage of durable medical equipment of Medicaid is the provider for medical equipment. Medicaid will compensate you if you choose the provider that will meet the following requirements set by Medicaid:

  • The provider must be accredited by a national organization
  • The provider must have a valid HME license and qualifications in accordance with the laws
  • The provider is not involved in any fraudulent cases or abuse

These are the basic requirements your provider must possess in order for you to get the reimbursement from Medicaid. You can check this site to see more qualifications.

3. Based On Where You Reside

Medicaid will provide coverage ONLY  for the following places that include the following:

  • Your home
  • The home of your family
  • A group home
  • A custodial care facility
  • An assisted living facility

4. Non-covered DME Services And Items

There are certain services, items, or equipment that are not covered by Medicaid. You can see below some of the items that are not reimbursed by Medicaid through the DME program. For the full list of the items, kindly check this site for your guidance.

  1. Dentures
  2. Disposable supplies such as gloves, blood testing strips, catheters
  3. Electric lifts
  4. Emergency and non-emergency alert devices
  5. Environmental modifications such as a bathroom, home, ramps, etc
  6. Experimental equipment
  7. Furniture that does not serve a medical purpose
  8. Hand-held shower
  9. Items used for cosmetic purposes
  10. Physical fitness equipment
  11. Scooters
  12. Standard car seats
  13. Television, VCR machines, radio, and other items intended to produce music or for entertainment purposes

Generally, most of us have a policy on insurance companies such as Medicaid; however, there are still some people who are not covered for this kind of service or medical equipment. Therefore, you might be wondering about other options to get medical equipment without any insurance. Well, no worries, since I have some helpful tips for you that you can look for when the time comes.

Other Options To Pay Durable Medical Equipment

The most common method used to pay for expenses that include medical equipment is through the use of your insurance policy from Medicaid, Medicare, Private Insurance, and others. However, for some people who do not have, there are still ways on how to get one.

Here are the tips below:

Look For A Local Lending Program

There are some local non-profit organizations that have programs wherein you can borrow medical equipment for free. In fact, these organizations solely rely on donations from people who no longer need medical equipment; thus, the items are cleaned and repaired by the organization before they lend to people who need them.

You can check your local Area Agency on Aging or some religious organizations to find out if they have lending programs for medical equipment. 

Buy It Yourself

There are some instances wherein you really need the medical equipment right away. That is why instead of waiting for your insurance company’s approval or searching for a lending program, you might opt to buy it yourself. There are many shops where you can find quality medical equipment at a reasonable price. It does not mean that it will cost you an arm and a leg to purchase one.

 Hence, here are my personal suggestions on where to look for:

  1. Amazon
  2. CVS
  3. Walgreens
  4. Goodwill
  5. Salvation Army,

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