How to Get a Hospital Bed or Wheelchair Through Medicare (Simple Steps)

If you’re enrolled in Medicare and need medical equipment like a hospital bed or wheelchair,
you’re not alone—and you’re not out of luck. Medicare can help cover many types of Durable
Medical Equipment (DME), but you need to follow the right steps. Unfortunately, this is one area
where a lot of people get confused or end up paying more than they should.

Let’s walk through everything you need to know in plain, simple language.

What Counts as Durable Medical Equipment (DME)?

First things first—DME is equipment your doctor prescribes for use in your home to help manage a medical condition or recovery. To qualify for Medicare coverage, the item must be:
  • Medically necessary
  • Able to withstand repeated use
  • Used for a medical reason
  • Used in your home
  • Expected to last at least 3 years

Common Medicare-Covered DME Includes:

  • Hospital beds
  • Wheelchairs (manual or power)
  • Walkers
  • Canes
  • CPAP machines
  • Oxygen equipment
  • Patient lifts
  • Nebulizers
  • Commode chairs

Does Medicare Cover Hospital Beds and Wheelchairs?

Yes—if your doctor says it’s medically necessary and writes an order for it.
For a Hospital Bed:
Medicare will cover:
  • Manual, semi-electric, and sometimes fully electric beds (based on medical need)
  • Side rails
  • Mattresses
You must:
  • Have a condition that requires frequent changes in body position
  • Be confined to bed in your home for medical reasons
For a Wheelchair:
To qualify, you must:
  • Have limited mobility due to a health condition
  • Be unable to perform daily activities like bathing, dressing, or getting out of a chair even with a cane or walker
  • Have a doctor’s written order
  • Be able to use the device safely in your home

What Will Medicare Pay?

Most Durable Medical Equipment is covered under Medicare Part B.
You Pay:
  • The Part B annual deductible (in 2025, that’s $257)
  • 20% of the Medicare-approved amount for the equipment
💡 Tip: If you have a Medicare Supplement (Medigap) plan, that 20% may be covered in full. If you’re on a Medicare Advantage (Part C) plan, coverage rules and Costs may vary.

Step-by-Step: How to Get DME Like a Hospital Bed or Wheelchair

1. Visit Your Doctor

Schedule a visit with your primary care provider or specialist. They need to:
  • Assess your condition
  • Document why the equipment is necessary
  • Write a detailed order or prescription

2. Find a Medicare-Approved Supplier

Only Medicare-enrolled suppliers who accept “assignment” can give you the lowest cost. Assignment means they’ve agreed to charge no more than the Medicare-approved price.
  • Visit Medicare.gov’s supplier search tool
  • Call ahead and confirm they:
    • Accept Medicare assignment
    • Have the equipment you need
    • Will handle billing to Medicare
3. Have the Supplier Submit the Claim
Once your supplier has your doctor’s order, they’ll submit a claim to Medicare (or your Medicare Advantage plan if that’s what you have). Never pay out-of-pocket upfront unless you’re absolutely sure the supplier is Medicare-approved.
❗️If a supplier does not accept assignment, you could end up paying much more than necessary—even hundreds more.

What If I’m in a Medicare Advantage Plan?

Medicare Advantage (Part C) plans must cover DME, but the rules, networks, and copays vary by plan. You’ll typically need to:
  • Use a plan-approved provider
  • Get prior authorization
  • Call your plan’s customer service number to confirm the steps

What Happens If Medicare Denies My Request?

Sometimes, Medicare will deny a claim for DME if:
  • The documentation wasn’t complete
  • The supplier didn’t follow protocol
  • The item wasn’t considered “medically necessary”
You can:
  • File an appeal (instructions are on your Medicare Summary Notice)
  • Contact your doctor and supplier to fix the issue
  • Ask for help from a local SHIP counselor (State Health Insurance Assistance Program)

Avoid These Common Mistakes

  • Don’t buy from a random medical supply store
    • If they don’t accept Medicare assignment, you could be stuck with the full bill.
  • Don’t skip the doctor visit
    • You must have a current order on file. No prescription = no coverage.
  • Don’t wait until the last minute
    • Some equipment (like power wheelchairs) can take time to approve.
  • Don’t assume Medicare covers everything
    • Some items like grab bars or shower chairs may not be covered.

445 Broadhollow Rd. Suite 25, Melville, NY 11747

Final Thoughts: You Don’t Have to Navigate This Alone

Getting a hospital bed, wheelchair, or other equipment through Medicare isn’t always simple—but it is doable when you follow the right steps. Whether you’re recovering from surgery, managing a chronic condition, or just need some help at home, Medicare may be able to lighten the financial burden.
🧡 If you’re ever unsure whether something is covered—or how to take the next step—it’s always worth asking. A trusted advisor can help make it easier.

(Mail: PO Box 465, Brightwaters, NY 11718)

📞 Phone: 631-774-3786

📧 Email: mmilinsurance@gmail.com

🌐 Website: mymedicaremike.com

Choosing the Right Medicare Coverage

Selecting the best Medicare coverage depends on factors like your healthcare needs, budget, and preferred providers. You can choose between:
  • Original Medicare (Parts A & B): Allows you to see any doctor or
    hospital that accepts Medicare but does not include prescription drug
    coverage (Part D) or additional benefits.
  • Medicare Advantage (Part C): Offers bundled coverage with
    potential extra benefits but may require using a network of providers.
  • Medigap (Medicare Supplement Insurance): Helps cover
    out-of-pocket costs not covered by Original Medicare, such as
    copayments and deductibles.

Key Medicare Enrollment Periods

It is crucial to enroll in Medicare at the right time to avoid penalties and ensure continuous coverage:
  • Initial Enrollment Period (IEP): A seven-month window starting
    three months before your 65th birthday month.
  • General Enrollment Period (GEP): From January 1 to March 31
    each year for those who missed their IEP.
  • Annual Election Period (AEP): From October 15 to December 7,
    allowing you to switch or enroll in Medicare Advantage and Part D
    plans.
  • Open Enrollment Period(OEP): From January 1 to March 31 for
    those who missed AEP and want to make certain changes.
  • Special Enrollment Period(SEP): Can be used anytime during the
    calendar year for those that meet certain criteria such as moving to a
    new service area.

Finding Help with Medicare

Understanding Medicare can be complex, but you don’t have to do it alone. Licensed Insurance Brokers, Medicare.gov, and state health assistance programs can provide guidance tailored to your specific needs.
By taking the time to explore your Medicare options, you can make informed decisions that ensure you receive the healthcare coverage that best suits your lifestyle and budget.
Do I have to sign up for Medicare?
It depends upon your current coverage. If you are employed and your employer has over 20 employees then you can delay signing up for Medicare and avoid penalties.
No, You will have to enroll in a stand alone Part D plan or a Medicare Advantage Plan(Part C) to get coverage.
There are no networks with Medicare and most doctors and hospitals accept it. However, Medicare does not cover 100% of services so a Medicare Supplement or Medicare Advantage plans is advisable.

Mike Miligi- Owner

For over 10 years, Mike has been assisting Seniors and other Medicare-eligible individuals in understanding the ins and outs of Medicare and Medicare Health Insurance options, including Medicare Advantage Plans(Part C), Medicare Supplement Plans(Medigap), Prescription Drug Plans(PartD), and Dental and Vision programs.
Mike is Licensed in seven States and Certified with 11 Insurance Carriers. He has helped thousands of individuals decide on the best course of action for their particular Health Insurance needs. Because Mike is an Independent Medicare Health Insurance Broker, he works for the client, not the Insurance Carriers, and is able to provide his clients with accurate and unbiased Health Insurance options.
Mike recertifies with CMS(The Centers for Medicare and Medicaid Services) annually, regularly completes Continuing Education Courses required by individual State Insurance Departments, and keeps abreast of industry trends and standards to offer his clients the most up-to-date information.
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