If you have cancer in your bones or bed sores, it can be painful to lie in one position for very long, which can make for sleepless nights. And sleep is of utmost importance for health as well as frame of mind. If you’re signed up with a local hospice organization, they will bring you a bed with an Alternating Pressure Mattress and Pump System. These mattresses have air cells, or tubes, that continuously inflate and deflate, changing contact points every 5,10, or 15 minutes, dispersing pressure as well as stimulating blood flow, which also helps to prevent and heal bed sores as well as pressure and decubitus ulcers. Some hospices have a shortage of beds so you might have to get on a waiting list.
You can also buy them at online medical supply stores. You can get a mattress and pump (without the bed) for under $500, but remember the old adage: “You get what you pay for”. The less expensive mattresses are going to have smaller air cells, say, 4″ compared to 8″ for a good mattress. For someone in a lot of pain, or someone over 120lbs, these smaller air cells may not help at all. Also, better mattresses will have a backup battery so if the power goes out the mattress will continue to work.
These mattresses fit most “hospital” beds. The advantage of using these beds is the guard rails, which will keep you from falling out of bed once you’re asleep and will let you adjust your lying/sitting position for eating, watching TV or reading, or getting up. If you don’t have a hospital bed, you can rent or rent-to-buy one.
MEDICARE
Medicare will cover a hospital bed when you can show a medical necessity for the bed. You must also be covered under Medicare Part B and have been assessed by your doctor. The doctor must document your need and write you an order (prescription) for the equipment. Only your doctor can prescribe the equipment for you, so do not order anything until you have visited your doctor, no matter what the sales person tells you.
To qualify for a hospital bed you must show that you:
- Change positions in ways not possible on a normal bed
- Lay or sleep in positions not possible with a normal bed in order to relieve pain
- Have to sleep with the head of the bed higher than 30 degrees because of conditions such as congestive heart failure, breathing problems, or other types of problems
- Use traction equipment that must be attached to a hospital bed
- Have a Certificate of Medical Necessity that is completed, signed and dated by the treating doctor.
The above is the basic criteria for coverage for hospital beds. There are number of different kinds of beds, such as an adjustable hospital bed. Each will have additional requirements for coverage. Your treating doctor and/or your supplier will know what needs to be documented in order for you to qualify for the bed and equipment that is right for you.
After you have paid your annual deductible, you will pay 20 percent of the Medicare-approved amount for the hospital bed purchase or rental and maintenance If you have MediGap/Supplemental insurance you may have little to no out-of-pocket cost.
You will save money if you order your items from a Medicare approved provider. Suppliers must meet strict standards to qualify and will have a Medicare supplier number. You may also buy your hospital bed from any store that sells them. However, if the supplier from which you order your bed is not enrolled in Medicare, Medicare will not pay for the equipment. Things you should think about before you choose a supplier:
- There are two types of Medicare suppliers: participating suppliers and those who are enrolled, but have chosen not to participate.
- Participating suppliers will not charge more than the Medicare allowed amount.
- A Medicare approved provider who does not want to participate can charge more than the Medicare-approved amount. However, they cannot charge more than 15 percent above the Medicare-approved amount. They may also ask you to pay the entire bill when you pick up the bed. In this situation, Medicare will send the reimbursement directly to you. However, be prepared to wait; it may take a couple months to receive payment.
- If you receive your Medicare coverage through a Medicare Advantage Plan (HMO or PPO), it is likely that the plan will have its own steps for the purchase. In addition, the plan may have restrictions on which suppliers you can use.
What a superb resource! I know that when my mom was hospitalized, the first thing she noticed was how much the bed hurt her back, and she wasn’t a large person at all. She was tiny but had arthritis and a history of spinal surgery, in addition to the terminal heart condition. As soon as Mom got into bed, she hurt. The nurse immediately got one of these “air mattresses,” as they were called, and put it on Mom’s bed. I could see from the look on her face that it gave her total relief, and for a caregiver, there is nothing better than seeing your loved one truly comfortable. Mom was able to relax and sleep peacefully, without tossing and turning or needing extra pain meds.
Unfortunately, when I was in the hospital a few years later for my first major surgery, there were no such mattresses available (different state) and I could barely walk by the time I was released. Three days and two nights in that rock hard bed with the paper thin mattress just about did me in. I can’t imagine how painful it would have been for a long-term illness.
Once again, a valuable insight, Jean. So often, we caregivers are so busy managing all the big picture things that we forget how important something like the proper mattress is to our loved one.
Thank you for all your caring and sharing!
Debora
Like
0
Debora, when my husband Dan was in the hospital I didn’t know to ask about the air mattresses – I ended up bringing in a big down comforter and fluffing and folding it up to put under him. ~ Jean
Like
0
You know, Jean, when Mom was released from the hospital and came home, we never thought to ask about using Medicare to get one for her at home, either! Now that I have had a chance to read some of the many wonderful posts here, I realize that I could have done more. Our bedrooms were on the second floor of our house and Mom could never make it up the stairs, so she spend the last two and a half months at home on our sofa. I piled up as many blankets and fluffy things I could find to make her comfortable, but they kept shifting and I was constantly having to straighten out everything to make her comfortable. It was hard on my back, and it was during one of those times that I had my “bad caregiver” moment. I was so exhausted and in so much physical pain from doing absolutely everything that I let all my frustrations show for one haunting second. If only I had realized that there was a better way to make her comfortable and that there is NO rule that says a caregiver must do everything by herself! Thank God you are here to help current caregivers hear that and get some relief.
Many blessings to you always, dear Jean.
Debora
Like
0
Thanks for sharing some of your story, Debora. This is the main reason we’re here: to allow others to learn from our caregiver mistakes. Nevertheless, I’m sure your mother was grateful to be on your couch, in your home, with you caring for her, and that if she’d been offered a comfortable bed in a hospital instead, she would have readily declined. Familiar surroundings and having your loved ones around you is the best medicine. You did good. ~ Jean
Like
0
Aw, thank you, Jean, and so did you!! Mistakes or not, we did what we did out of love, and that makes just about everything right. ~ Debora
Like
0
I’ve worked in hospice for 15 years and, if an individual has been admitted to hospice care, any medical equipment, supplies or medications that are related to the life-limiting illness are covered by hospice. Hospice is reimbursed on a per-diem schedule, meaning that the agency receives a predetermined amount per day and, for this reimbursement, is required to provide complete care for the “hospice” illness. The Hospice Team serves as care manager for the hospice illness and makes all determinations regarding what items are considered related to the illness. Medicare’s hospice benefit is the model for most private insurance policies and generally there is no out-of-pocket expense for the patient or family. Details of the Medicare hospice regs can be found at http://www.cms.hhs.gov/hospice
Information is power and this blog is a wonderful place for sharing knowledge. One of the last things a caregiver should have to worry about is paying for care of a loved one! Thank you, Jean, for making this forum available!
Like
0
Thank you, Sandi, for clarifying that for us, and for the link! ~ Jean
Like
0