Does Insurance Cover Stair Lifts?
It is a valid question we get quite often – Does insurance cover stair lifts? Unfortunately, no, insurance does not cover stair lifts in the majority of cases. Common Medicare Advantage providers that customers believe may cover stair lifts include AARP, Blue Cross Blue Shield, Aetna, United Healthcare, Cigna, and Humana. Below, we will examine each insurance provider’s policy on stair lift coverage. This article focuses on Medicare Advantage Plans. For additional information about why Original Medicare does not cover stair lifts, visit our Medicare article.
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You must be cautious when seeking information on whether or not your insurance company covers stair lifts. The customer service representatives of many providers are unaware of exactly what a stair lift is. They will tell you they cover stair lifts, due to this lack of understanding. Most insurance companies do cover “Seat Lifts” and/or “Lift Chairs.” While these terms may sound interchangeable with the term “Stair Lift,” they are not the same. A seat lift or lift chair is designed to make getting out of a chair or recliner easier.
One way to be certain of what type of equipment they cover is to ask for the HCPCS code (also known as billing code) that covers stair lifts. Medicare and Medicare Advantage providers use this system of codes to determine which products and services they cover and which they do not. Ask your provider what code they provide stair lift coverage through, more than likely, they will state one of the codes listed below. These codes do not cover stair lifts.
HCPCS – E0627, E0628, E0629
The Centers for Medicare & Medicaid Services (CMS) describes these codes as “Seat lift mechanism.” A seat lift is not a stair lift, but instead, what is commonly referred to as a lift chair or power lift recliner. They are most often recliners that raise up, off of the floor to aid the user in standing up from the chair. Stair Lifts are not covered under these HCPCS codes.
HCPCS – E0625, E0630, E0635, E0636, E0637, E0638, E0639, E0640
CMS describes these HCPCS codes as “Patient lifts.” These are commonly referred to as Hoyer lifts. They are designed to aid in the transfer of a user from a wheelchair or bed to a chair, bath, or restroom, or assist with standing from a seated position (sit-to-stand lift). Stair Lifts are not covered under these HCPCS codes.
Stair lifts likely fall under the code S5165 “Home modifications; per service,” although they are not specifically called out. However, it is widely documented that Medicare does not pay on this code. You can ask your provider if they cover HCPCS S5165.
Does AARP Cover Stair Lifts?
No, AARP does not cover stair lifts. They state: “Medicare considers all these improvements—including stair lifts or elevators for people unable to climb stairs because of their physical condition—as items of convenience rather than of medical necessity.” To view on the AARP website, visit the link here: AARP Stair Lift Policy
Does Blue Cross Blue Shield Cover Stair Lifts?
No, Blue Cross Blue Shield does not cover stair lifts. The policy states “Chair lifts (i.e., stairway elevator-like devices) and/or modifications to vehicles are not in benefit.” The policy can be viewed here: Blue Cross Blue Shield Stair Lift Policy
Does Aetna Cover Stair Lifts?
No, Aetna does not cover stair lifts. Their policy states: “Aetna does not cover the following types of lifts because they are considered home modifications: Platform lifts, stair lifts/stairway chairs, elevators, and stairway elevators (e.g., Stair Glide chair).” The policy can be viewed directly on their website: Aetna Stair Lift Policy
Does United Healthcare Cover Stair Lifts?
No, United Healthcare does not cover stair lifts. Their policy states: “The following services are excluded from coverage: stair lifts and stair glides.” United Healthcare’s policy can be viewed here: United Healthcare Stair Lift Policy
Does Cigna Cover Stair Lifts?
No, Cigna does not cover stair lifts. Their policy states: “The following items are each considered one or more of the following, even if the item is not specifically excluded under the benefit plan: Not primarily medical in nature, a self-help or convenience item and/or not medically necessary: stairway chair/stair lifts.” The policy can be viewed directly, here: Cigna Stair Lift Policy
Does Humana Cover Stair Lifts?
No, it is unlikely that Humana covers stair lifts. While we have been unable to find a policy specifically excluding stair lifts from coverage, it is highly unlikely that Humana covers stair lifts. If you would like to inquire further, we recommend asking under what HCPCS code they provide coverage. Then refer to the above section regarding the HCPCS Codes. If you have further questions, don’t hesitate to contact us.
While it can be frustrating to find out that your insurance does not pay for a stair lift, there are other ways to lessen the cost of a stair lift. Value based offerings like the Harmar Pinnacle SL300 are an affordable option for anyone looking for a new stair lift. Additionally, purchasing a used stair lift or renting can be other great ways to reduce cost. If you are interested in a stair lift for your home, or have more questions about Medicare or Medicare Advantage, please contact us, we would be happy to help.