Beds By George Medicaid/insurance

Beds By George adaptive beds may be covered by insurance, both private and Medicaid,  provided you can satisfy their requirements.

Quality Local Home Medical Supply stores are VERY helpful in getting insurance approvals.   We can help you with some authorizations to private insurance and grants.  If you plan to request assistance from Medicaid you MUST use one of these stores.

Standard Requirements:

While each insurance company may vary, in general two basic requirements are necessary in addition to the authorization forms required by your insurance provider:

1) Prescription from the USER’s doctor for the exact brand and model of bed and medical features it needs. (it is the same idea as prescribing medication)  Example 1:  patient needs Beds by George model 1700F with IV pole.   Example 2: patient needs a twin size bed with 360 degree unbroken perimeter and safety sides that exceed 30 inches in height above the sleep surface and has the ability to raise the head to 60 degrees.

2) Letter of Medical Necessity and some insurance companies will prefer an LOMN from a medical professional (therapist, ATP, RTS, etc)  and appropriate supporting documentation.  The same examples from (1) apply.

In an increasing number of cases, insurance companies will have a standard form for “Medical Necessity” that must be filled out by the physician ordering the bed. You may want to consider writing a letter in addition to that document.

Medicaid / Waiver Requirements

There are many specific requirements based on coverage and the state you live in.  Here are a few common questions.

  1. Will BBG submit the claim?  Only local Home Medical supply companies that are registered DME’s (Durable Medical Equipment) or the care giver can submit authorization requests to Medicaid.   Beds by George will work with these DME’s but we cannot submit these claims directly.
  2. I have both private insurance and Medicaid.  Do I only have to submit my request to one of them?  No, you should submit a request to both.  If you have both private insurance and medicaid, you have to get an answer from private insurance before medicaid will process your request.
  3. If private insurance approves me, will Medicaid automatically cover the difference?  Medicaid approval is not directly related to private insurance approval and vice versa.  In other words we have seen where one will approve where the other will not all the time.  The amount of coverage is completely dependent upon your insurance policy(s).

Disclaimer:

The information on this page is opinion.  We in no way guarantee insurance coverage nor reimbursement for our products.  The information here is for informational purposes only and may or may not assist you in securing funding for medical equipment. It is in no way implied that if you follow these steps or use these examples you will be granted funding. Insurance coverage, application, circumstance, and policies vary. Be advised every case, every agent, and every insurance company is different. We strongly recommend that you communicate with your provider(s) and research other sources for information as well.

For sample letters please contact info@bedbygeorge.com“