A question we get almost weekly from customers is if insurance will pay for a seat lift chair for themselves or their loved ones. Here is what we can tell you:
Medicare and all other insurance companies that we used to be contracted with only covers the seat lift mechanism of the lift chair, not the chair itself. Medicare considers the lift mechanism medically necessary, not the chair itself. Below is a portion of the coverage guidelines from the Medicare Local Coverage Determination for the seat lift mechanism.
A seat lift mechanism is covered if all
of the following criteria are met:
1. The beneficiary must have severe arthritis of the hip or knee or have a severe neuromuscular disease.
2. The seat lift mechanism must be a part of the treating practitioner’s course of treatment and be prescribed to effect improvement, or arrest or retard deterioration in the beneficiary's condition.
3. The beneficiary must be completely incapable of standing up from a regular armchair or any chair in their home. (The fact that a beneficiary 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 beneficiaries who are capable of ambulating can get out of an ordinary chair if the seat height is appropriate and the chair has arms.)
4. Once standing, the beneficiary must have the ability to ambulate.
The practitioner ordering the seat lift mechanism must be the treating practitioner or a consulting practitioner for the disease or condition resulting in the need for a seat lift. The practitioner's record must document that all appropriate therapeutic modalities (e.g., medication, physical therapy) have been tried and failed to enable the beneficiary to transfer from a chair to a standing position.
We currently stock seat lift chairs in our retail showroom but do not file insurance for them. We are happy to show you all the available options in terms of price, style, and features as well as discuss possible payment options through CareCredit financing if you qualify.
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