Medicare Reimbursement Inquiry
If you have Medicare coverage and qualify, Medicare will reimburse you for the
cost of the lift mechanism inside the chair. This is approximately $300 depending
on which Medicare region you’re in. Many of our customers file for Medicare
coverage.
Only the seat lift mechanism on a lift chair could be considered medically necessary
if all of the following coverage criteria are met:
• The patient must have severe arthritis of the hip or knee or have a severe
neuromuscular disease.
• The seat lift mechanism must be a part of the physician’s course
of treatment and be prescribed to effect improvement, or arrest or retard deterioration
in the patient’s condition.
• The patient must be completely incapable of standing up from a regular
armchair or any chair in their home. (The fact that a patient has difficulty
or is even incapable of getting up from a chair, particularly a low chair, is
not sufficient justification for a seat lift mechanism. Almost all patients who
are capable of ambulating can get out of an ordinary chair if the seat height
is appropriate and the chair has arms.)
• Once standing, the patient must have the ability to ambulate (walk).
• Coverage of seat lift mechanisms is limited to those types which operate
smoothly, can be controlled by the patient, and effectively assist a patient
in standing up and sitting down without other assistance. Excluded from coverage
is the type of lift which operates by spring release mechanism with a sudden,
catapult-like motion and jolts the patient from a seated to a standing position.
Coverage is limited to the seat lift mechanism, even if it is incorporated into
a chair.
How do I file?
You will need 3 things:
• A doctor's prescription
• The bill of sale
• And a Certificate of Medical Necessity (CMN)
We will provide you with the bill of sale either through email or via the U.S
Postal Service. You may obtain the CMN right here by just clicking on one of
the two manufactures Golden Lift Chairs or Pride Lift Chairs (You will need Adobe
Acrobat Reader (R) to view files. Click here if you experience problems viewing
form.).
You then take or mail the CMN to your specialist for their completion. Once completed
by your doctor, mail the CMN, bill of sale, and the doctor's prescription to
your Medicare regional claims office. If approved, you will receive a check back
for reimbursement.
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