Insurance Eligibility: What Qualifies You for Coverage and How to Get Approved
When it comes to insurance eligibility, the set of rules that determine whether you can get financial help for medical equipment or home health services. Also known as coverage qualification, it’s not about having insurance—it’s about proving you need specific items to live safely at home. Many people think if they have Medicare or private insurance, they automatically get coverage for things like lift chairs, hospital beds, or special mattresses. That’s not true. You need a doctor’s note, documented medical need, and the right paperwork. Without those, even the best insurance plan won’t pay a cent.
Medicare coverage, a federal health program for seniors and people with certain disabilities. Also known as government health insurance, it only pays for durable medical equipment, devices meant for repeated use that serve a medical purpose. Also known as DME, it includes items like wheelchairs, oxygen tanks, and yes—lift chair prescription, a doctor’s written order for a power lift recliner due to mobility issues like arthritis or Parkinson’s. Also known as mobility aid prescription. The key? Your condition must limit your ability to stand or sit without help, and your doctor must say the chair is medically necessary—not just convenient. You can’t get approved just because you want to relax easier.
It’s the same for hospital beds. If you can’t turn in bed safely, or you have severe COPD and need to sleep upright, Medicare may cover it. But if you just think a fancy bed looks nice? Nope. The system isn’t designed for comfort—it’s designed for safety and function. That’s why so many people get denied. They don’t connect their daily struggles to the medical terms insurers require. A simple note from your doctor saying "patient cannot transfer from bed without assistance" can make all the difference.
You’ll also need to buy from a supplier that accepts Medicare assignment. That means they agree to take what Medicare pays as full payment—no extra charges. Skip the big-box stores. Go through certified DME providers. They know the forms, the codes, and the deadlines. And yes, you’ll need to keep records. Medicare might ask for proof of use, like photos or follow-up notes. Don’t assume approval is automatic. It’s a process. One that thousands of seniors skip because it feels too complicated. But once you get it right, you could save thousands.
What you’ll find in the posts below are real examples of how people got approved—for lift chairs, hospital beds, and other gear. No fluff. No theory. Just what worked: the exact words doctors used, the forms they filled out, the mistakes that caused delays, and how to avoid them. Whether you’re helping a parent, planning ahead for yourself, or just trying to understand why insurance denied your request, these stories give you the clear, step-by-step path forward.
