Does Medicare cover stair lifts?

Medicare’s policy on stair lifts

Medical insurance professionals say original Medicare rarely covers stair lifts because they don’t qualify as durable medical equipment (DME). “Stair lifts are considered (permanent) home modifications, not medical necessities, under Medicare guidelines,” Evan Tunis, president of Florida Healthcare Insurance, an agency in Coral Springs, explained.

According to Garrett Ball, owner of 65Medicare.org, an independent Medicare insurance agency, to qualify as DME under Medicare, the equipment must meet the following criteria:

1. Be intended for long-term use
2. Be intended for home use
3. Serve a medical purpose
4. Be reusable

Even though Medicare doesn’t cover stair lifts, Medicare Part B does cover mobility devices when a doctor prescribes them, Whitney Stidom, vice president of Medicare enablement at the health insurance marketplace eHealth, told us. This includes (but isn’t limited to) hospital beds, patient lifts, walkers, oxygen equipment and accessories, wheelchairs and scooters.

Medicare Advantage and stair lifts

“Some Medicare Advantage plans do offer some coverage for stair lifts,” Tunis noted. However, coverage varies between plans and locations. “To check if a Medicare Advantage plan covers stair lifts, contact your [provider] directly or read through your coverage document for terms such as ‘home modification benefit,’ ‘fall prevention’ or ‘home safety devices,’ ” Stidom advised.

Pre-authorization is necessary if you need a stair lift and want your insurance company to help cover the cost. To get this, your doctor will need to submit evidence of medical necessity to your insurance company, Stidom explained. If the insurance company agrees to cover it, it may pay a portion, but typically not the entire cost.

Pro tip

The fall’s Annual Enrollment Period (AEP) presents an opportunity to find better coverage options. Shop around because “benefits can differ from one Medicare Advantage plan to another,” Stidom said. She recommends working with a licensed benefit advisor to find the right plan based on your needs, healthcare goals and budget.

» RELATED: Will Medicare pay for nursing homes?

Alternative funding options for stair lifts

Alternative funding options for stair lifts include the VA, nonprofit organizations, local charities and state-based programs, according to Ball. Each has different eligibility requirements and application processes.

Medicaid may offer the most accessible path for many seniors. “If you meet certain ‘level of care required’ requirements (and are) a Medicaid recipient, you may qualify for assistance with stair lift costs,” he noted. Unlike Medicare, Medicaid often covers home modifications through Home and community-based services waivers when they help people avoid nursing home placement.

In addition to Medicaid, you may find these funding avenues helpful:

• Federal and state housing programs: The Department of Housing and Urban Development (HUD) has limited funding for home modifications, but it’s still worth looking into. Contact your local HUD office to learn about programs in your state that help seniors with accessibility improvements.
• Fundraising: Online crowdfunding platforms can help you raise money for a stair lift with support from friends, family and your community.
• Home equity: If qualified, you may explore tapping into your home’s value through a home equity loan or line of credit (HELOC) to pay for a stair lift. These financing options often have lower interest rates than personal loans or credit cards.
• Private health insurance: Call your provider and ask about their requirements for stair lift coverage. Some private insurers cover medically necessary mobility devices as long as a doctor prescribes them.
• Veteran programs: Veterans injured while in service can apply for stair lift assistance through VA Health Care. It often funds mobility devices that Medicare doesn’t, including stair lifts. You don’t have to worry about existing Medicare or Medicaid benefits affecting your coverage.

Costs and financial considerations

Stair lift costs depend largely on whether your staircase is straight or curved. The investment also varies based on your staircase design and the type of stair lift you choose.

Generally, straight stair lifts are the most affordable option. On average, you can expect to pay $3,000 to $8,000. Curved stair lifts, which must be custom-manufactured to fit your staircase, range between $10,000 and $15,000 due to their complexity.

It’s possible to save money on your stair lift purchase and installation with some research and planning:

• Ask about rental programs if you need a stair lift temporarily.
• Get multiple quotes from different manufacturers and installers.
• Look into refurbished or used models, which can cost 50% less than a new unit.
• See if you can take advantage of financing plans with low or zero interest.

Pro tip

Beyond the stair lift purchase price, account for long-term costs, such as repairs, maintenance and possible modifications. Experts recommend budgeting around $400 per year for these needs. While this adds to your investment, it can prevent expensive emergency repairs later.

» MORE: Tips to choose the best stair lift for your house

Resources for financial assistance

Knowing where to turn for financial help with a stair lift can mean the difference between affording one or not.

“The best starting point would be [getting in touch with] your local council on aging,” Ball emphasized. It’s a central point for resources on programs and grants to help with stair lift costs. Find your local council through The National Council on Aging’s website.

Many states offer home modification programs through housing departments, providing financial aid based on age, income and medical need.

When applying for financial assistance, preparation is key:

• Apply to multiple programs at once to increase your chances.
• Document your income and assets according to program requirements.
• Gather several quotes from reputable stair lift companies.
• Get a written prescription from your doctor explaining medical necessity.
• Take photos of your staircase to demonstrate the need.

Beyond state programs, the area agencies on aging (AAA) — a network of over 600 agencies serving older adults — are excellent resources. These agencies provide information, support services and help with applications for various senior aid programs. You can find your local Area Agency on Aging by visiting eldercare.acl.gov or calling 800-677-1116.