Medicare Coverage for Adjustable Beds in 2026

Medicare Coverage Overview for Adjustable Beds

Medicare classifies adjustable beds primarily as durable medical equipment (DME) when they meet specific medical necessity criteria. Coverage generally extends to hospital beds, including adjustable beds with features intended to assist individuals with certain medical conditions. However, Medicare does not cover adjustable beds purchased for general comfort or convenience.

Conditions Medicare Recognizes for Coverage

Medicare may cover adjustable beds or hospital beds fitted with pressure-reducing mattresses if the equipment is prescribed to treat or manage conditions such as:

• Severe mobility impairments (e.g., paraplegia or quadriplegia)
• Chronic wound care needing pressure relief (e.g., stage III or IV pressure ulcers)
• Recovery from serious injuries such as a broken hip or spinal cord injuries
• Severe arthritis or other musculoskeletal conditions requiring elevated positioning for comfort or function

The need for the equipment must be documented by a healthcare provider through a prescription or medical order.

Durable Medical Equipment and Coverage

For Medicare purposes, an adjustable bed may be covered under Part B as DME if it meets the criteria of being primarily medical in nature and used in the home. This coverage often includes hospital beds specifically designed for patient care, which may have adjustable features such as raising and lowering the head or foot sections.

Mattresses designed to reduce pressure and prevent bedsores can also be covered if prescribed alongside a hospital bed. These mattresses, sometimes called therapeutic or pressure-relief mattresses, are considered part of the DME when medically necessary.

Limits on Coverage

Medicare does not cover:

• Adjustable beds purchased solely for comfort or convenience
• Standard mattresses without demonstrated medical necessity
• Accessories or features not directly related to medical care
• Adjustable beds used in institutional settings unless meeting strict criteria

Furthermore, coverage typically does not include mattresses or beds purchased from retail or furniture stores unless the supplier is enrolled and approved by Medicare as a DME supplier.

Process for Obtaining Medicare-Covered Adjustable Beds

To qualify for Medicare coverage of an adjustable bed or specialized mattress, a beneficiary must have a doctor’s written order stating the medical need. The equipment must be obtained from a Medicare-approved DME supplier.

Medicare Part B generally covers 80% of the approved amount for DME once the beneficiary has met their Part B deductible. The patient is responsible for the remaining 20% coinsurance unless supplemental insurance covers this cost.

Documentation supporting medical necessity and careful selection of suppliers are important to ensure coverage.

Considerations for Back and Hip Pain

Many individuals seek adjustable beds for relief from back, hip, or joint pain. While these beds may offer comfort, Medicare does not cover adjustable beds or mattresses that are intended exclusively for pain relief without verifiable medical necessity.

Beneficiaries should consult with a healthcare provider to determine if their condition qualifies them for coverage. For example, adjustable beds used as part of treatment for spinal cord injuries or severe arthritis may qualify, whereas general pain management needs typically do not.

Typical Costs in United States (2026)

When considering adjustable beds in the United States, price ranges vary widely depending on features and quality. Typical costs in 2026 include:

• Basic option: Around $500 to $1,000 - often manual adjustable beds or hospital-style beds with limited features, suitable for users with minimal adjustment needs.
• Standard option: Approximately $1,000 to $3,000 - motorized adjustable beds with remote controls, multiple positioning options, and some integrated therapeutic mattress functions.
• Premium option: Typically $3,000 to $6,000+ - includes advanced adjustable beds with features like massage functions, split king sizes, advanced pressure-relieving mattresses, and higher-end technology.

Medicare coverage generally applies only to the equipment meeting medical necessity criteria, typically hospital beds and medical mattresses, not to features for convenience or luxury.

Additional Information and Considerations

• Medicare Part A usually does not cover adjustable beds unless provided during a hospital stay.
• Medicare Advantage Plans (Part C) may have additional rules for coverage and should be reviewed separately.
• Durable Medical Equipment suppliers must be enrolled in Medicare and should provide documentation and billing aligned with Medicare rules.
• Beneficiaries should be cautious about purchasing beds or mattresses from non-approved suppliers or retail outlets expecting Medicare coverage, as most do not qualify.

Summary

In 2026, Medicare coverage for adjustable beds is limited and focused on beds and mattresses defined as durable medical equipment with documented medical necessity. Coverage usually applies to hospital beds prescribed for specific health conditions and pressure-reducing therapeutic mattresses. Standard adjustable beds purchased for comfort or non-medical purposes are generally not covered. Understanding Medicare’s criteria and supplier requirements can help individuals navigate coverage options and related costs.

This information is intended for informational purposes based on current Medicare policies as of 2026 and does not constitute medical or legal advice. Policies and coverage can change, and individuals should consult Medicare resources or healthcare providers for specific guidance.