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  • Bed choices

    Ok so here we go between my insurance and the wife's it has now been decided by the doctors that I need a bed of my own. Doc said an adjustable one that's hi low. Now what manufactures make these. My doctor mentioned hill rom. She said these are very nice beds. I am gonna check with my insurance to see what manufactures they use. Also needs to be low air loss! I know drive and inovacare make them. My niece has a sleep safe bed in hi low full size witch I like. Both her side rails go up and down. I like her bed
    Last edited by randomryan007; 04-05-2013, 06:21 PM.

  • #2
    Bed is the frame. Mattress is another issue. You don't have to buy them from the same company. Hill-ROM makes hospital beds primarily for the hospital (and not the home care) market....and I personally don't like their hospital beds.

    Invacare makes a home care bed, but it has springs for the "pan" of the bed (what the mattress sits on). This allows for a lot of mattress sag, and many find them uncomfortable and difficult to use for bed ADLs like dressing or self-cathing. In addition, their standard home care bed does not go low enough to the ground (even in low, you are higher than your wheelchair, so wheelchair to bed transfers are up-hill). If you need an ECU, you also want to be sure you can get a bed frame that is compatable with that so you can run the controls yourself if you have limited hand function. Generally you should be looking for a full-electric, high/low bed frame, and ideally one that has an extra low feature, and that has either a solid or slat or metal non-spring grid pan.

    Many hospital beds cannot be used for homecare as they can't be disassembled to get up stairs or through narrow doorways. You might be able to get one into your bedroom if your bedroom has a sliding glass door to the outside...it just depends.

    As far as mattresses, a low air loss or fluid immersion simulation mattress will give you the lowest pressures, but these come at a high cost. Is your insurance going to cover this?? Medicare will not unless you already have a stage III or IV pressure ulcer (they won't pay for these for prevention). Many other insurances follow Medicare rules when it comes to mattresses.

    (KLD)
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

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    • #3
      Ok where would one be able to find these beds to speak of. My Gastro wants me to have my new bed before I have gallbladder surgery. As far as mattresses what mattress will insurance cover? This is all new to me so I am very confused!

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      • #4
        What insurance do you have?

        (KLD)
        The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

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        • #5
          I have Medicare and cigna

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          • #6
            I have to deside soon about the bed. As my dme is pushing me! Yet I still don't know my options! They said pick something and they will put it through to see if my insurance will aprove it! Really is this normal?

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            • #7
              If Medicare is your primary, it is unlikely you will get to purchase a bed frame. They nearly always require a rental, and may not approve a full-electric bed frame either. Your DME should know this already.

              Medicare will not pay for a LAL mattress unless you ALREADY have a stage III or IV pressure ulcer. If that is not the case, then it is likely you would have to private pay for a LAL. Your DME should know this too.

              Most private insurances also follow the Medicare rules, and I suspect Cigna is your secondary or Medicare supplement, correct??

              (KLD)
              The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

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              • #8
                Cigna is my secondary

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                • #9
                  Originally posted by SCI-Nurse View Post
                  If Medicare is your primary, it is unlikely you will get to purchase a bed frame. They nearly always require a rental, and may not approve a full-electric bed frame either. Your DME should know this already.

                  Medicare will not pay for a LAL mattress unless you ALREADY have a stage III or IV pressure ulcer. If that is not the case, then it is likely you would have to private pay for a LAL. Your DME should know this too.

                  Most private insurances also follow the Medicare rules, and I suspect Cigna is your secondary or Medicare supplement, correct??

                  (KLD)
                  So you get a pressure sore.....medicare pays 500,000 for sore then buys you a bed....nice savings huh?

                  This just does not make sense.
                  Art

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                  • #10
                    Originally posted by Art454 View Post
                    So you get a pressure sore.....medicare pays 500,000 for sore then buys you a bed....nice savings huh?

                    This just does not make sense.
                    It is the federal government (Medicare). Sense, and logic (and fairness) are not part of the equation. I learned that many years ago.

                    (KLD)
                    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

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                    • #11
                      What about a sealed stage IV sore, or sores? I've heard once a stage IV, always a stage IV. Does that apply to getting a mattress?
                      Alan

                      Proofread carefully to see if you any words out.

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                      • #12
                        I was told we had to buy our own mattress. My doctor is fighting it

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                        • #13
                          Originally posted by alan View Post
                          What about a sealed stage IV sore, or sores? I've heard once a stage IV, always a stage IV. Does that apply to getting a mattress?
                          You are right Alan, but unfortunately Medicare (and most other insurances) do not see it that way.

                          (KLD)
                          The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

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                          • #14
                            Will the dme rent you a bed while you decide? Some equipment that's rented reverts to your ownership after a period of Medicare rental. I have a cough machine under that arrangement.

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                            • #15
                              "Medicare will not pay for a LAL mattress unless you ALREADY have a stage III or IV pressure ulcer. If that is not the case, then it is likely you would have to private pay for a LAL." (SCI Nurse)

                              I already have a low air loss mattress and need a new control unit. I currently do not have any pressure ulcers but have had some bad ones (surgically repaired) and am at high risk. I'm guessing that I'll need to forget about possible reimbursement from Medicare, is the same true for Medicaid? Does this vary from state to state Medicaid?
                              1 Corinthians 13:13

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