Medicare Coverage on Lift Chairs: Your Guide for 2025

Many people experiencing mobility challenges due to aging, arthritis, or a recent surgery consider purchasing a lift chair to make everyday movements easier. While these chairs can be essential for independent living, they can also be costly, often running into the hundreds or even thousands of dollars. Understandably, many Medicare beneficiaries wonder whether their Medicare health insurance might help cover some of the cost.

Stairlift9Image by Ursula Fischer from Pixabay

What is a Lift Chair?

A lift chair is essentially a comfortable recliner that has a built-in seat-lift mechanism. Unlike a stair lift or a patient lift, a lift chair is a standalone piece of furniture that assists users by tilting and elevating the seat, making it easier to stand up or sit down without additional help. The design and materials often resemble a typical living room recliner, so it can blend into the home setting.

Does Medicare Pay for a Lift Chair?

Medicare Part B or a Medicare Advantage Plan (Part C) may cover the seat-lift mechanism of a lift chair as durable medical equipment (DME) if it is medically necessary for improving your condition or slowing deterioration. However, Medicare does not cover the entire chair, only the lifting component. Here are the essential requirements and steps for getting Medicare coverage for a lift chair:

1. Medicare Coverage Type

You must be enrolled in Medicare Part B or a Medicare Advantage Plan (Part C) to qualify for coverage. If you have a Medicare Advantage Plan, contact your private insurer for coverage rules, potential costs, and any specific supplier requirements.

2. Certificate of Medical Necessity

A medical necessity certificate, specifically Medicare Form CMS-849, also known as the “Certificate of Medical Necessity for Seat Lift Mechanisms,” must be completed by your physician. Sections B and D of this form are essential for certifying that a lift chair is necessary for your treatment or condition management.

3. Medical Necessity Criteria

To qualify for coverage, Medicare requires that:

  • You have severe arthritis in the hip or knee or a severe neuromuscular disease.
  • You are unable to stand from a regular chair independently.
  • Once standing, you can walk independently or with assistance from a walker or cane. Note that if you use a wheelchair to transfer, Medicare may not cover the lift chair.
  • The seat-lift mechanism is part of your physician’s treatment plan and will either help improve your condition or prevent further deterioration.

4. Medicare-Participating Supplier

The lift chair must be ordered from a Medicare-participating supplier who accepts assignment. Without this, Medicare will not cover the chair, and you could be responsible for the entire cost.

Costs of a Lift Chair with Medicare Coverage

If you meet the qualifications for a lift chair, Medicare will cover only the seat-lifting mechanism portion of the chair—not the entire chair itself. Medicare reimbursement for the lift mechanism varies by state but generally falls around $300. You will be responsible for the remaining balance of the chair’s total cost.

Similar to other items covered under Medicare Part B, after paying the annual deductible, beneficiaries are responsible for 20% of the Medicare-approved amount for the seat-lift mechanism if purchased from a supplier who accepts assignment.

Where to Buy a Lift Chair

To ensure Medicare coverage for the seat-lift mechanism, it’s important to choose a Medicare-participating supplier who accepts assignment. Here are the steps:

  1. Visit Medicare.gov: Use the Medicare Supplier Directory to find Medicare-approved suppliers who accept assignment for lift chair seat-lift mechanisms.
  2. Search by ZIP Code: Enter your ZIP code and select the “Seat Lift Mechanisms” category.
  3. Choose an Approved Supplier: Look for suppliers marked with an “M” symbol, which indicates that they accept Medicare assignment, meaning they’ll accept the Medicare-approved amount as full payment for the seat-lift mechanism.

For beneficiaries enrolled in a Medicare Advantage Plan, follow your plan’s specific guidelines to ensure coverage. It’s advisable to contact your plan’s customer service to confirm the approval and purchase process for the lift chair.

What Are the Enrollment Periods for Medicare Part A and Part B?*

You can only enroll in Medicare Part B (and/or Part A if you need to buy it) during specific enrollment periods:

  • Initial Enrollment Period: Generally, you can first sign up for Part A and/or Part B during a 7-month period that begins 3 months before the month you turn 65 and ends 3 months after that month. If your birthday falls on the first of the month, this period starts 4 months before you turn 65 and ends 2 months after.

    Example: If you turn 65 on June 2, your enrollment period runs from March through September. If you turn 65 on June 1, the period runs from February through August.

    If you enroll in Part A and/or Part B during the first 3 months of your Initial Enrollment Period, your coverage typically starts on the first day of your birthday month. However, if your birthday is on the first day of the month, coverage begins the first day of the prior month. If you sign up during your birthday month or in the final 3 months of your Initial Enrollment Period, coverage starts on the first day of the month after you sign up.

  • Special Enrollment Period: Once your Initial Enrollment Period ends, you may still have a chance to sign up during a Special Enrollment Period. For example, if you didn’t sign up for Part B (or Part A if you need to buy it) because you had group health plan coverage through current employment (yours, a spouse’s, or a family member’s if you have a disability), you can enroll in Part A and/or Part B:

    • Any time you’re still covered by the group health plan.
    • During the 8-month period that begins the month after either employment or coverage ends, whichever comes first.

    Typically, coverage starts the first day of the month after you sign up. If you enroll in Part B while still working or in the first full month after your employment coverage ends, you can request to delay the start of your Part B coverage by up to 3 months.

    In most cases, signing up during a Special Enrollment Period means you won’t have to pay a late enrollment penalty. Note that this Special Enrollment Period does not apply if you’re eligible for Medicare due to End-Stage Renal Disease (ESRD) or if you’re still within your Initial Enrollment Period.

Bottom Line

If you or a loved one requires assistance from a lift chair for everyday mobility, Medicare Part B or a Medicare Advantage Plan may provide some financial relief. While Medicare does not cover the full cost of the chair, it may cover the seat-lift mechanism as durable medical equipment. By following Medicare’s requirements, consulting with your doctor, and choosing an approved supplier, you can avoid unnecessary costs and get the support needed to improve your quality of life.

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