If you or a someone close to you are considering a sleep to stand bed or lift bed and are wondering whether or not Medicaid can cover it, the process and steps can seem overwhelming and difficult. While Medicaid coverage is different by state, county and even individual circumstances, this will hopefully act as a general guide to help you in navigating the application and review process.
How Medicaid Coverage Works
Medicaid is both a state and federally funded program that helps to provide healthcare assistance to certain individuals who meet specific requirements. Coverage for durable medical equipment (DME), such as a sleep to stand bed, or other similar units depends on whether Medicaid considers it "medically necessary" under its rules and guidelines. Each state has its own rule set, so it’s a must to research with your specific state’s Medicaid headquarters.
Steps to Apply for Medicaid Coverage
1. See If Your Eligibile
Medicaid coverage is typically based on a few factors including but not limited to income, household size, and several other factors. To check if your a valid applicant, check out your specific state’s Medicaid website or use the federal Medicaid eligibility tool at Medicaid.gov.
2. Get a Doctor’s Recommendation
To apply for Medicaid coverage for a sleep to stand bed, you will usually need a prescription or letter of medical necessity from your doctor. Your healthcare provider can then assess your condition and determine whether this type of bed is essential for your long term care.
3. Find a Medicaid Approved Supplier
Medicaid usually requires that DME or similar products be purchased from an approved seller. You can search for providers on your own or through your state’s Medicaid website or ask the seller if they work with Medicaid-approved suppliers. If you have a seller you would already like to purchase from you can communicate with a Medicaid representative to see if they can approve the product through them.
4. Submit an Authorization Request
Some states require prior authorization before Medicaid will cover any sort of DME equipment. This means your doctor and DME provider may need to submit paperwork demonstrating the necessity of the equipment for your needs.
5. Follow Up on Your Application
After submitting your request, Medicaid will review your request and proceed to determine if the bed or DME meets their or the situational coverage criteria. Processing times vary, so regularly check with your specific Medicaid office for updates on your case.
What If Coverage Is Denied?
If Medicaid denies covering a sleep to stand bed or other DME, you have the right to appeal the decision through their system. Your denial letter will include detailed instructions on how to file your appeal through their system. You may also want to explore alternative funding options, such as nonprofit organizations or payment plans offered by sellers.
Final Thoughts
Applying for Medicaid coverage for a sleep to stand bed requires extended documentation and and deep understanding of state and federal requirements. By working with your healthcare provider and an approved seller you can increase the chances of obtaining coverage through Medicaid. Always check with your state Medicaid office for the most accurate and up to date information.
For more guidance, or questions about applying through Medicaid, you can reach out to us at (702) 329-4584 or if your looking for further information about sleep to stand bed check out our line up at https://livelyliftbeds.com/