Follow
Share

Does a pressure relief mattress or an overlay has to have FDA approval to get it reimburse through Medicare or Insurance company ? I saw this mattress called Purple on the internet. They are offering there solution for bedding. Even the reviews are so good and i though i should buy one for my immobile Dad. The mattress is like $999 and i want to know whether i can get it reimburse through Medicare or Insurance.

This question has been closed for answers. Ask a New Question.
Find Care & Housing
What medicare wants is a written order from an MD, prescribing a certain kind of mattress. For your Dad as an example the MD may write a prescription for an adjustable bed and a bariatric mattress. Your insurance company will then tell you which products they will cover.
I will tell you that for $999 you can buy an entire hospital bed with a premium mattress included. OR if you rent one, medicare covers 80%
Helpful Answer (0)
Report

To me it does not look that much different than "Ghost Mattress" or "Casper Mattress"
Not sure either one or any of them would be great for a bed bound or immobile person.
Some one that is not able to re position themselves should have a mattress that will provide movement unless you want to move the person into a different position every 2 hours or more often.
Also there will come a time, if you are not having this problem now where the bed will get wet/soiled with urine. I would think a foam mattress would be the last thing you would want unless there is a washable, waterproof cover over it.
You can ask the doctor about it and if they think it is beneficial they can write an order for it and you can submit the bill. If medicare turns it down but you still have the order it may be written off when doing your taxes as a medial deduction.
But I would ask the doctor about some of the Hospital beds with the air flow mattresses. A hospital bed will come in much more handy as you have to do more and use more equipment to transfer your Dad. A hospital bed can be raised and lowered making it easier to get in and out of, easier to make, easier to change a person and easier to re position them.
Helpful Answer (1)
Report

I don't believe Medicare would pay for non-FDA products but others may. Our "Friendly Beds" will never be paid by Medicare but has been covered by Medicaid waivers, workmans comp, the VA, and partially/fully covered by disability orgs, Centers for Independent Living (over 500 government agencies tasked to keep people at home- see www.ILRU.org). Occasionally covered by insurance but they will kick and scream all the way. There are also foundations that offer grants for certain disabilities. Medicare language is that they cover "the least expensive medical necessity" meaning typical cheap items- heavy duty/superior stuff not covered. Hope this helps people that are struggling with getting funding assistance- I have info on the various grants available and would be glad to offer suggestions if I know what the issues are.
Helpful Answer (0)
Report

Your doctor signs off (yes, a written doc) on what his/her patient requires and then Medicare covers it.
Helpful Answer (0)
Report

FriendlyBedGuy, Thank You for explaining the different insurance coverages.My Husband is using Veteran's Choice for part of his care, he suffers from PAD, other blockages through his entire body. He sleeps with both legs off the bed most of the night. We are looking into possibilities to relieve his pain, some sort of adjustable bed would be a God send. My question would be since my husband has both medicare A&B , as well as VA coverage...which would be most likely to his needs. He is receiving primary care through VA and Cardiology treament through Veterns Choice and Medicare...Any help would be appreciated, He is 68 yrs. old and I have been caring for him for 16 yrs. He has COPD, and sleep Apnea both causing many sleepless nights..Thanks everyone for a wonderful online site that is so helpful
Helpful Answer (0)
Report

Insurance companies would need a doctor's prescription and "Letter of Medical Necessity" as well as a formal quote to even have a chance of approval. The VA spends a great deal of money to keep veterans safe and at home (as they should) and you would need to get the VA medical professionals to spec what is needed. Sweetpea- an adjustable bed is often needed to address respiratory/gastro/circulatory problems but they often go the cheap hospital bed route (which are often uncomfortable). The VA can buy non-FDA items (like ours) if the need is there but each location has their own set of crazy rules. Despite that I think the VA may be your best chance of getting help. Also check out any funding help you may be able to get from your local Centers for Independent Living (www.ILRU.org). Good luck.
Helpful Answer (1)
Report

This question has been closed for answers. Ask a New Question.
Ask a Question
Subscribe to
Our Newsletter