How To Get A Mattress Under Medicare In 2023

Having a sturdy and comfortable mattress to sleep on at night is essential for both our physical and overall well being. Lack of good quality sleep leads to a number of ailments and conditions, such as chronic fatigue, irritability, and lack of focus. However, quality and healthy mattresses are usually quite expensive.

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Fortunately, depending on various conditions, you may qualify for Medicare coverage. For instance, if you’re at least 65, meet certain criteria and a doctor has deemed it medically necessary for you, Medicare will cover the larger majority of the cost.

There are four types of Medicare – Type A, Type B, Type C and Type D, which all offer coverage in different areas of health and medical care. When it comes to mattress coverage, you’ll first need to be signed up for type B, which offers coverage for DME’s (Durable Medical Equipment). This type of Medicare covers 80% of the total cost, then the remaining 20%, plus a monthly premium, must be paid by the patient. Additionally, you may even qualify to own the mattress instead of merely renting it, but this depends on your individual health / medical case and recovery process requirements.


Eligibility Rules And Conditions

There are two main factors that need to be considered in order to qualify for Medicare coverage: The patient’s overall health condition / medical situation, and the mattress itself. It’s important to note that the only kind of mattresses that receive DME status are pressure-reducing mattresses which are fully recognized by Medicare. These specialized mattresses are designed to reduce pain caused by various health and medical conditions, and as a means of healing after an operation or injury.

The patient must provide proof that the mattress is a “medical necessity” for them, which is obtained by the following:

– An attending physician must write up a definitive prescription stating that the mattress is a medical necessity for the patient, and provide relevant medical documentation.

– The physician must also be Medicare approved and have examined the patient personally at least six months before the prescription was given.

– The mattress must be for use in the patient’s place of residence.

– The mattress can only be acquired via a Medicare authorized DME provider.

– The claim for coverage needs to be made in advance and receive prior authorization from Medicare.

– Typically, If the claim is for a replacement DME mattress, at least five years must have passed since the approval of the prior DME mattress.

– Lastly, if Medicare approves the mattress, any deductible on the patient’s Part B coverage must be paid by the patient first before the Medicare coverage goes into effect.

Listed below are some of the most highly recommended DME pressure reducing mattresses that can be covered by Medicare in 2023.

Drive Medical Alternating Pressure Low Air Loss Mattress System

This impressive machine can adjust the pressure of the mattress, giving varying yet steady pressure as needed. It is also equipped with a quiet electric pump that helps the patient sleep well. This is usually controlled by a hand-held control device and provides friction reduction and microclimate control.
This system is specially designed to be used in the prevention and treatment of pressure ulcers.

The mattress includes 20 air bladders, with nine laser holes to achieve the low air loss function and to increase patients comfort by keeping the affected area cool and dry. The Aire cells are 8″ high and are constructed with 40% nylon/60% PVC for longevity and durability. The zippered mattress cover is constructed with a quilted, urethane coated nylon fabric which is water resistant, vapor permeable, machine washable and low sheer, safeguarding the patient’s skin and ensuring maximum comfort.

Plus, it has an LED display and audible alarms which provide critical performance data and alert a caregiver when the pressure falls below 10mmHG.

Drive Medical Therapeutic 5-Zone Support Mattress

This mattress possesses five zones and provides supreme support and comfort by distributing weight and pressure evenly. It is constructed of durable and soft foam that is horizontal and cross-cut. It also features a 2-way stretch cover that reduces friction and shear. Better yet, It is vapor permeable, anti-microbial and water-resistant to provide patients with maximum comfort and health protection. It features a non-skid bottom that keeps the mattress securely in place and a removable nylon cover.

The mattress has a solid supportive foam core, topped with a thick cross-cut corrugated layer. The top portion helps to redistribute pressure, and the cut channels help with air-flow to keep you cooler than traditional foam construction.

ThevoRelief Pressure Relief Mattress

The ThevoRelief mattress is designed for people with arthritis, body aches, sores and other discomforts. It features unique and effective wing suspensions that create a soft and comfortable sleeping surface. The integrated MiS Micro-Stimulation® technology gently stimulates the body’s nerve tracts, relieving not only the patient’s soreness but also making it easier for caregivers so they no longer need to provide support throughout the night.

Additionally, the ThevoRelief Pressure Relief Mattress is an excellent choice for cancer patients, as it is helpful in reducing the intensity of some common side-effects associated with chemotherapy, such as nausea and physical weakness.

Solace Resolution Glissando Heavy Duty Mattress

The Solace Resolution Glissando Mattress is designed to prevent friction and shear, which can contribute to pressure ulcer development, while providing comfort for the patient. Its special “gliding” layer provides excellent protection against friction, and the high density foam reduces pressure on the body. The individual sections of foam can move independently to work with adjustable beds. This mattress also features a fluid resistant cover that helps to keep the mattress clean and dry.

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