Insurance Coverage for Lift Chairs – A Practical Guide

If you’re looking at a lift chair, the first thing most people wonder is whether insurance will pay for it. The short answer: sometimes, but it depends on your policy, medical need, and paperwork.

Lift chairs are considered medical equipment when a doctor prescribes them for a health condition. That prescription is the key to unlocking coverage from Medicare, Medicaid, or private insurers. Without a doctor’s note, you’re usually on your own.

Who Pays for a Lift Chair?

Medicare Part B covers lift chairs if you have a documented mobility limitation and a home health professional writes a prescription. The chair must meet specific durability standards, and the cost you’ll pay is typically 20% of the allowable amount.

Private health plans often follow a similar rule: a medical necessity letter, a supplier’s invoice, and a prior‑authorization form. Some plans cap the amount they’ll reimburse, so check the fine print.

Medicaid varies by state. Some states cover lift chairs under the Home and Community Based Services (HCBS) waiver, while others treat them as normal durable medical equipment (DME). You’ll need to contact your state’s Medicaid office for exact rules.

How to File a Claim and Maximize Reimbursement

First, get a clear prescription from your physician. Ask them to include the diagnosis, why a lift chair is essential, and the specific model recommended.

Next, choose a supplier that works with insurers. Most reputable vendors will handle the claim paperwork for you, but it’s smart to verify they’re listed in the insurer’s approved provider network.

When you receive the invoice, double‑check the itemized costs. Insurance often only pays for the chair itself, not accessories or delivery. If you’re billed for extras, you may need to cover those out‑of‑pocket.

Submit the claim with the prescription, invoice, and any required claim forms. Keep copies of everything; insurers sometimes request the original documents.After the claim is processed, you’ll get an Explanation of Benefits (EOB). If the amount paid seems low, you can appeal. Common grounds for appeal include missing diagnosis codes or an outdated policy reference.

Don’t forget about warranties and extended service plans. While they’re not insurance, they can save you money on repairs after the initial coverage period ends.

In summary, insurance can cover lift chairs, but you need a solid prescription, an approved supplier, and careful claim handling. By following these steps, you’ll avoid surprises and get the most out of your policy.