Does Medicare Pay for Stairlifts? | A Consumer’s Guide
Getting older is part of life, but many folks don’t think of that when they purchase a home with multiple floors! Seniors who have staircases as part of their houses may prefer to remain in their homes as they age, which is an understandable impulse. However, many seniors also experience mobility issues as they get older, making it more difficult or impossible for them to ascend a staircase and get to several important rooms in the home, like the bedroom. A stairlift could be an excellent solution to this problem. Stairlifts are motorized seats that are attached to the staircase treads of a stairwell to rise automatically to the top or back down as needed. Riders can take a seat, press a button, and ascend the stairs without having to risk injury from a fall or pain for their mobility issues. However, stairlifts can be quite expensive, so many ask if Medicare will pay for stairlifts. Let’s dive deep into this question and see which plans offer opportunities for coverage and which do not.
How Much Does a Stairlift Cost?
The exact cost of your stairlift can vary tremendously depending on the unit and the difficulty of installation. New stairlifts consistently range in price between $2500 to $9500; these prices reflect the cost for both the stairlift itself and the installation fee. If you purchase a stairlift that does not come with an installation service (not recommended), you must be prepared to pay between $500 in $2000 for professional installation assistance.
The cost of your stairlift can be affected by various factors. For instance, straight staircases are much more affordable because of the lowered installation difficulty and standard components. Curved staircases or staircases with landings require a custom curved rail stairlift and may add additional cost to the purchase and installation. Note that the width of your staircase normally doesn’t add to the cost, but it may limit the types of models you can use; narrow staircases have fewer options than wider staircases.
Additionally, the length of your stairway will affect the installation cost and the price of the stairlift unit itself. The majority of stairlifts come with enough track to cover up to 15 ft, although many also allow you to purchase additional track for around $50-$100 per foot of space.
Indoor stairlifts are usually the most cost-effective while outdoor stairlifts are more expensive because of the additional durability concerns. Outdoor stairlifts must be made to withstand the elements and continue to function even in inclement weather.
The weight of the users also plays a big factor in stairlift costs. The majority of stairlifts are designed for people weighing less than 300 lbs. Stairlifts designed for heavier individuals will be between $500 and $100 more expensive than standard model stairlifts.
Then you need to consider any extra features that may be included in the stairlift design. For instance, most newer stairlifts have folding seats, arms and footrests to let them transform or fold back for those who want to walk up the staircase normally. Other stairlifts may have power options or additional padding for rider comfort. Material cost plays a big role; stairlifts with fancy upholstery or custom paint will be more expensive. Finally, some stairlifts can swivel for easier rider access, while others are more rigid.
More modern stairlifts may have additional safety features and innovations like motion sensors, call buttons or even braking systems to prevent accidents. They are normally powered by batteries that constantly charge when the stairlift is parked. This allows the stairlift to operate as normal even when the house loses power.
You’ll need to consider all of these features before purchasing a stairlift depending on your needs, budget, and aesthetic preferences.
Medicare’s Stairlift Coverage
Standard Medicare coverage generally only covers medically necessary equipment and mobility devices. Under their guidelines, stairlifts require improvements or changes to the stairwell or the superstructure of your home. Thus, standard Medicare coverage considers stairlifts to be medical devices for personal comfort or convenience rather than a medically necessary device. They do not cover stairlifts as a result.
There is a single exception to this; at times, standard Medicare coverage may pay for a small amount of the total cost of the stairlift if it has an elevating seat component. This component would, in theory, help the individual using the chair sit down or get up safely from the mobility device. In a roundabout way, this portion of the stairlift could be called medically necessary and could thus be covered under original Medicare.
However, the rest of the cost of the chair lift would need to be covered from either your own funds or from another insurance provider.
Furthermore, Medicare supplemental (also called Medigap) insurance does not cover stairlifts. This insurance is specifically designed to help you with co-pays for goods and services or deductibles for those services covered by original Medicare. As original Medicare doesn’t cover stairlifts, this type of insurance will not be any help either.
Medicare Advantage Stairlift Coverage
As of 2019, those in need of a stairlift have been able to turn to Medicare Advantage Plans. In a nutshell, these plans are newer evolutions of Medicare and provide the same kinds of benefits through private-sector health insurers. This means that the plans must adhere to several of the same guidelines and standards that regular Medicare insurance plans must.
However, many private-sector health insurers who are part of Medicare Advantage plans contain supplemental benefits. This includes vision, hearing, and dental costs, which means that everyday convenience and mobility devices like stairlifts may be covered under Medicare Advantage plans if they are deemed medically necessary for the senior in question by a licensed medical professional.
Even better, 2020 will see the further evolution of Medicare Advantage plans. They will be able to offer even more supplemental benefits for those with chronic illnesses, which often require the assistance of a stairlift. In this way, Medicare Advantage plans may be appropriate for finding funding for your stairlift installation and maintenance coverage.
However, whether you qualify for this coverage will vary depending on the plan you have at the moment. Some healthcare providers will likely jump on this opportunity for extra clients but others may stick closer to the classic original Medicare regulations. You’ll need to review your plan’s coverage carefully and may consider changing healthcare providers if a competitor begins offering stairlift cost coverage.
Medicare Part B
Medicare Part B is a variety of Medicare plans that covers “durable medical equipment” that is primarily used in the home. However, these plans come with a caveat; that they don’t pay for either the construction or installation of any permanent changes to your home’s physical structure. Stairlifts would qualify as home improvements and disqualify the medical device as a result.
As an example, Medicare Part B normally covers lifts that help the patient get in and out of bed or another chair, as these are normally freestanding devices that aren’t physically attached to the home in question. Stairlifts, by definition, are attached to the staircase and are thus technically part of your home.
Medicare Part B does not normally qualify stairlifts as durable medical equipment.
Like with original Medicare, there’s a small loophole you may be able to take advantage of. Depending on the construction of your home and the design of your stairwell, a Medicare-certified equipment supplier in the installation specialist could technically install a stairlift that does not require changes to the superstructure of the stairway. In essence, they would have to install your stairlift without having to make it a physical part of your home, or at least not in a permanent way. Unfortunately, at this time, there are no stairlifts available that provide these features.
If this was possible, the stairlift could then be covered by Medicare Part B. This being said, the majority of stairwells are designed such that stairlifts must be attached to their structures and become permanent parts of the stairs themselves.
You can check the Medicare website for an official list of durable medical equipment suppliers in your area. You can contact the suppliers individually by phone and explain your problem and see if they have a stairlift design that would fit the above qualifications. They may need to send a specialist out to look at your stairwell and determine whether the construction and installation of such a device is possible.
Remember that your stairlift needs to be deemed medically necessary and prescribed by your doctor and installed by a provider approved by Medicare in order to be covered by this option.
Summary of Medicare Coverage
As in stands, Medicare Advantage plans are your best bet for obtaining coverage for your stairlift through Medicare. They provide you with the same plethora of benefits the regular Medicare plans do, but may include additional coverages that allow you to get your stairlift covered.
Additionally, no matter which Medicare plan you attempt to get coverage through, you must remember that your stairlift must be deemed medically necessary in order to qualify for any kind of government assistance. This can normally be proven through a doctor’s order or note. Any other kind of stairlift must be paid for by yourself or through another insurance option.
Lastly, even if your Medicare Advantage plan covers a stairlift, it may only cover certain types of stairlifts based on what the Medicare-approved providers have or are qualified to install. These may or may not meet your accessibility needs based on their specifications and type. Therefore, even if you can get a stairlift covered by Medicare, you should make sure that it will be a stairlift that will work for your needs before accepting.
Alternative Stairlift Funding Options
Medicaid and Waivers
You may be able to get your stairlift covered either in whole or in part by Medicaid depending on the state in which you reside. Specifically, the Home and Community-Based Services program allows some Medicaid members to get health services in their own homes instead of at a medical institution or clinic. This may also include the cost for the purchase and installation of a stairlift.
Medicaid allows for certain waivers in various states to cover the costs for home modifications and other supplemental healthcare benefits. These waivers are state-dependent, so you’ll need to double-check whether your state has the waiver for something like a stairlift before applying.
Additionally, you need to meet s specific income criteria to receive this type of medical assistance from your state government.
The Veteran Affairs office may provide you with benefits in the form of housing grants that help make your home more accessible. As a stairlift is designed to do just this, it may qualify under VA allowances or coverage depending on your state and your exact disability.
You can also turn to long-term care insurance or other insurance options that may cover home-improvement disability access improvements like a stairlift. These options will be covered in your plan’s benefits outline.
Home Improvement Loans
Depending on your insurance or your credit rating, you may qualify for home improvement loans. Stairlifts normally count as home improvements due to their nature and the fact that they require direct adjustment of a stairwell or banister. The exact amount may not cover the entire stairlift (for instance, it may cover just the installation), but it could make the total cost more agreeable.
Ultimately, Medicare will not pay for stairlifts in the vast majority of cases. You need a specific Medicare Advantage plan with a healthcare provider that includes stairlift coverage as a supplementary benefit in order to have this device covered by government insurance. We’d recommend that you check with your provider to see if they offer this coverage or if you can switch to a different provider.
In any case, there are alternatives you can turn to if Medicare will not work out, including other insurance options and even home loan grants or programs. Stairlifts can be installed and paid for through a variety of means, so even if one option doesn’t pan out, keep looking for one that does!