Medicare Mattress Options: What’s Covered, Costs & Access

If you’re searching for mattress options under Medicare, the rules can be confusing.

This guide explains what Medicare typically covers (and what it does not), how eligibility works, and how to access specialized sleep equipment through approved medical channels—without overpromising results.

What Medicare Covers (and What It Doesn’t)

Medicare generally does not cover standard retail mattresses—including most memory-foam beds, adjustable bases sold in furniture stores, toppers, or pillows—when they’re for comfort or convenience. These are considered personal items, not medical equipment.

Medicare Part B may cover certain sleep-related items as durable medical equipment (DME) when they’re medically necessary for use in the home and prescribed by a Medicare-enrolled doctor. Coverage can include hospital beds, pressure-reducing mattresses, low air loss or alternating-pressure systems, and mattress overlays designed to prevent or treat pressure injuries. After the Part B deductible, you typically pay 20% of the Medicare-approved amount if your supplier accepts assignment.

Coverage may be for rental, purchase, or a capped rental period depending on the item and your circumstances.

Think of DME as specialized clinical equipment with defined medical indications, not consumer bedding. If your goal is comfort alone, expect to pay out of pocket. If you have a documented medical need—such as mobility limitations, a history of pressure ulcers, or a condition that requires therapeutic positioning—Medicare may help with the right equipment when all coverage rules are met.

DME Types: Hospital Beds, Support Surfaces, and Overlays

Hospital beds for home use

A hospital bed can be covered when a doctor documents why a standard bed won’t meet your clinical needs—for example, if you require frequent body positioning that cannot be achieved with pillows, need head elevation beyond what a wedge can provide due to severe reflux or breathing issues, or require traction or specialized safety features. Models may be manual or semi-electric; fully electric features may not always be covered unless medically justified. Rails and trapeze bars can be covered when necessary for positioning and transfers.

Most hospital beds are provided on a rental basis first. If the supplier accepts assignment, you generally pay 20% coinsurance after the Part B deductible, and Medicare pays the rest of the approved amount. Over time, rentals may transition to ownership depending on the item category and local rules.

Pressure-reducing mattresses and support surfaces

These are therapeutic surfaces designed to redistribute pressure and manage moisture and shear—key for preventing and treating pressure injuries. Coverage criteria vary by product type and clinical severity. In general terms:

Group 1 surfaces (e.g., certain foam, gel, or air overlays/mattresses) may be considered when a beneficiary is at risk for pressure ulcers and requires basic pressure redistribution.
Group 2 surfaces (e.g., alternating-pressure or low air loss systems) typically require more significant risk factors or the presence of pressure injuries that have not improved with Group 1 measures, along with documented wound care and turning schedules.
Group 3 surfaces (e.g., air-fluidized beds) are reserved for severe, non-healing stage III/IV pressure injuries under strict criteria and are usually provided on a rental basis.

Exact requirements are defined by Medicare and your local DME Medicare Administrative Contractor (MAC). Your clinician and supplier will reference those policies when determining eligibility.

Mattress overlays

Overlays are placed on top of an existing mattress to add pressure redistribution. They can be a cost-effective solution when basic measures are appropriate. Coverage depends on the same medical necessity standards that apply to other support surfaces and requires a prescription and documentation.

Eligibility: Medical Necessity, Documentation, and Prescriptions

To qualify for Medicare-covered DME, three things must align: a clinical need, a compliant prescription, and an approved supplier. Here’s what that means in practice:

Medical necessity: Your doctor must document the diagnosis and functional limitations driving the need (e.g., limited mobility, risk or presence of pressure injuries, difficulty breathing lying flat). Documentation often includes prior treatments tried, skin assessments, wound staging (if present), and a plan of care (e.g., turning schedules, wound dressings).
Prescription/order: The order should specify the exact equipment, features, and medical rationale. Some items may require detailed written orders and supporting clinical notes. In certain cases, prior authorization may be required before delivery.
Home setting suitability: Medicare covers DME for use in the home. The home must accommodate delivery and safe use (e.g., space for a hospital bed, appropriate electrical outlets for powered systems).
Enrolled providers: Both the prescribing clinician and the supplier must be Medicare-enrolled. If the supplier doesn’t accept assignment, your costs can be higher.

How to Access Covered Equipment: Step by Step

Start with your doctor: Discuss symptoms, functional limits, and skin integrity. Ask whether a hospital bed, pressure-reducing mattress, or overlay is medically indicated. Your doctor will determine if you meet criteria and write a prescription with clinical notes.
Choose a Medicare-approved supplier: Use the Medicare Supplier Directory to find enrolled suppliers near you. Confirm they carry the specific item, accept Medicare assignment, and can help with any required prior authorization.
Confirm coverage and costs: Ask the supplier to estimate your portion after the Part B deductible and 20% coinsurance. Clarify whether the item will be rented or purchased and what happens if your needs change.
Authorize and deliver: For certain items (for example, some pressure-reducing support surfaces), Medicare may require prior authorization before delivery. The supplier usually submits paperwork, but you may need to sign forms or provide additional clinical notes.
Use and follow-up: Learn how to operate the equipment, practice safe transfers, and follow your care plan (e.g., repositioning schedule, wound care). Keep follow-up appointments so your clinician can document ongoing need.

Costs, Rentals, and Medicare Advantage

Under Part B, once you meet the annual deductible, you generally pay 20% of the Medicare-approved amount for covered DME if your supplier accepts assignment. Some items are capped rentals—you rent monthly up to a set period, after which you may own the equipment or continue service depending on the category. Repairs and maintenance rules vary by item and supplier.

If you have a Medicare Advantage (Part C) plan, you must follow your plan’s network rules, prior authorization requirements, and cost-sharing. Benefits may differ from Original Medicare, and some plans offer supplemental benefits. Always check plan documents or call your plan before ordering equipment.

For authoritative details on what counts as DME and typical cost-sharing, see Medicare’s page on durable medical equipment coverage.

Setting Realistic Expectations

Not all “medical-looking” beds qualify: Retail adjustable bases may look similar to hospital beds but lack required safety and clinical features—and don’t meet coverage criteria.
Documentation is essential: Coverage hinges on clear, timely clinical notes. If your condition or care plan changes, ask your doctor to update documentation.
Timelines vary: Prior authorization, equipment availability, and home delivery can add time. Plan ahead, especially if a discharge from the hospital is coming up.
Supplier choice matters: Working with an experienced, Medicare-participating supplier can streamline approvals and reduce unexpected costs.

Alternatives if Medicare Doesn’t Cover a Mattress

If your situation doesn’t meet DME criteria, consider these options:

Retail mattress features: Look for strong edge support for safer transfers, a medium-firm feel for spinal alignment, and breathable materials to reduce heat and moisture. Check trial periods and return policies.
Home safety add-ons: Bed rails designed for consumer beds, non-slip step stools, and transfer aids can improve safety—verify compatibility with your bed and follow manufacturer guidance.
Community resources: Medicaid home- and community-based services (if eligible), Veterans Affairs benefits, state Assistive Technology programs, local loan closets, or nonprofit grants may help with equipment or costs.
Talk to your clinician: Even if Medicare won’t cover a retail mattress, your clinician can suggest positioning strategies, overlays, or home therapy to improve comfort and skin protection.

Frequently Asked Questions

Does Medicare cover memory-foam mattresses?

Generally no. Memory-foam or hybrid mattresses sold at retail are considered personal items. Medicare may cover a therapeutic mattress or overlay when it’s classified as DME and medically necessary—based on your diagnosis and documentation.

What’s the difference between an adjustable bed and a hospital bed?

Retail adjustable beds are consumer products focused on comfort. Hospital beds are clinical devices with safety rails, precise positioning, and medical features. Only the latter, when medically necessary and prescribed, may qualify as Medicare-covered DME.

Do I need prior authorization?

Some DME categories—such as certain pressure-reducing support surfaces—may require prior authorization before delivery. Your Medicare-enrolled supplier will advise and submit paperwork when required.

How do I find a Medicare-approved supplier?

Use Medicare’s online Supplier Directory and confirm the supplier accepts assignment on your specific item to avoid unexpected charges.

Important: Coverage decisions are individualized. Always confirm benefits, medical necessity criteria, and costs with your clinician, your Medicare plan, and your supplier before ordering equipment.