Adjustable bed

Bob844

Hello, my name is Bob. I am very new at this, so please be patient if this issue was already spoken about. I just went through all my chemo and radiation treatments and finally the surgery (Feb.18th, 2016) at Brigham and Women's Hospital in Boston, Ma. I have tried the wedge pillows and the udner the knee wedge pillows, all with little to no help (keep sliding down). I was wondering if anyone who has Medicare and Medex, it they know if this insurance will cover the cost of an adjustble bed. If so, how does one go about getting this accomplished/ Any reponse is welcome, thank you in advance. (stage lll)

 

Bob

LorettaMarshall

Bob-Medicare helps w/cost of bed but U need doctor's RX

Good morning Bob –

First congratulations on making it through the pre-op chemo, radiation and surgery.  I see you’ve been diagnosed with Stage III, as was my husband William back in 2002.  He had pre-op chemo of Carboplatin and 5-FU, plus 25 radiation treatments, and then the Ivor Lewis Minimally Invasive Esophagectomy by Dr. James D. Luketich at the University of Pittsburgh Medical Center.  And we are now entering the 14^th year of survival with clean scans.  So now you’re on a different phase, that of adjusting to a new way of eating and sleeping.  But since you only asked about a bed, I will limit my comments to that need basically.  And indeed, sleeping in an elevated position is a “life-style” change for all Esophageal Cancer patients.  But it is one we don’t mind grappling with because we are “alive”.

My husband sleeps on a 12-inch wedge with pillows, and he’s okay with that.  We tried a 7-inch wedge at first, and that wasn’t at all sufficient.  Body weight pushed it down even further.  Before the wedge, we had tried “bed risers”.  Well, that was a joke.  We both wound up at the foot of the bed each morning, so “been there—done that!”

I will tell you that I know that “Paul61” purchased an adjustable bed and is very pleased with it.  Now he will be along no doubt, to tell you how he obtained his.  I don’t happen to know how he went about obtaining it.  I've sent him a private message and when he checks in, he will answer you in even greater detail.  He's filled with helpful information as well.  He had the traditional Ivor Lewis Esophagectomy with post chemo, but is now in his 5th year of cancer-free survival.  That's a milestone to shout about!

But I did call Medicare for you this morning.  (1-800-6334-2273)

And I don’t know what MEDEX is, but Medicare told me that “YES” if the doctor wrote a prescription for it, and it was a medical necessity, that Medicare would pay for 80% of the cost, and the patient must pay the difference.  Now it may be that if you have a supplemental plan as well, (if that is MEDEX), they may cover some of the cost in addition to what Medicare will pay. 

The “hitch” is that Medicare has a list of suppliers that will “accept” their payment for the bed.  No doubt the bed I would most likely to have would not be one that Medicare would pay for.  Women do like “pretty” things you know.  But “pretty” and “practical” don’t always go together.  So comfort is your main goal.

Isn’t there always a “hitch” Bob?  Now you may not want a “hospital bed”.  I see plenty of adjustable beds advertised on the web, that do not look like hospital beds.  And then again, if you have a wife, she may not want to sleep in the same position as do you.  But I’m certain that all the adjustable beds do not have to be double beds.  And I don’t know what is available that is “prettier” than a hospital bed.  Frankly, I would want one that didn’t look like a hospital bed because that would more likely make me feel like a “patient”, even when I was no longer one. 

So I suggest you speak with your physician that sees you on a regular basis, and have them write you a prescription that is “accepted” by Medicare.  Since all EC patients need to sleep in an elevated position, I am certain the doctors are familiar with this aspect of “recovery”.  They should do that much homework for you.  They know this is a necessity for you.  And the choice should be yours.

May God bless you and give you a years, years, and more years of cancer-free survival.  Life is precious, and yet isn’t always appreciated until you’ve had the prospect of losing it.  So congratulations on making it to the “recuperative” and “on-with-life” stage Bob.

Loretta Marshall

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Web link for Medicare 

1.  https://www.medicare.gov/coverage/hospital-beds.html

2.  https://www.medicare.gov/coverage/your-medicare-coverage.html?q=adjustable bed for esophageal cancer patient

 

paul61

Talk to your surgeon and request a medical order

Hello Bob,

Congratulations on completing your chemotherapy, radiation, and surgery. I also had Ivor Lewis surgery for esophageal cancer a little over 6 years ago. If you can persuade your surgeon to write a medical order that states that an adjustable bed is necessary because of the surgical changes you have, Medicare will cover a portion of the cost, and if you have supplemental insurance, it will typically cover the remainder. It would be covered under the “durable medical equipment” portion of your coverage.

If you are married I would recommend you get a king adjustable foundation that is actually made up of two standard single bed foundations. That way you can adjust your back and legs to a position that is comfortable for you that manages your reflux issues; and your wife can adjust her side to a position that is comfortable for her.

Most major furniture stores that carry beds and mattresses carry adjustable foundations and the appropriate bedding. Medicare has a list of merchants that will accept their payment process.

I recommend an adjustable bed highly, I tried several other approaches including a wedge and under knee pillow and bed risers and they just don’t work for me.

So I would speak to your surgeon, ask for the medical order, and then submit the order to Medicare for preauthorization. Even if your surgeon won’t write the order, I would think you could still purchase the bed on your own, and turn the cost in along with your other medical costs not covered by insurance at income tax time.

 Wishing you a quick and complete recovery,   

Best Regards,

Paul Adams

McCormick, South Carolina

 

DX 10/2009 T2N1M0  Stage IIB - Ivor Lewis Surgery  12/3/2009
Post Surgery Chemotherapy 2/2009 – 6/2009 Cisplatin, Epirubicin, 5 FU
Five Year Survivor

 

LorettaMarshall

Update~More info on adjustable beds that might interest you!

 

Good morning Bob – and I hope it is a good morning for you.  In looking through my recent COSTCO flyer, I see that they are advertising a “Split-King Memory Foam Mattress with Adjustable Base.  The picture shows a king bed with either side able to lay flat or be elevated.  It lists the item #as 695974 and yes it’s expensive.  But actually if I had known my husband would be alive 14 years later, I would have purchased something like this right after his MIE surgery, even if it did cost “an arm and a leg!”  So although I own no stock in COSTCO, I do see that they have adjustable beds in their inventory.   This one happens to cost $2,399.99 delivered and that’s after a $500 discount.  (That’s their sale price for now). 

 So if you weren’t able to get your doctor to write you a prescription for an adjustable bed, thought you might want to check out other sources.  They say that other sizes/configurations are available.  So I know that this is at least one place Esophageal Cancer patients can shop to find a bed that gives them a good night’s rest, if foam wedges and/or pillows stacked one on another are not sufficient.  I would think that all of us would buy a new bed, if they were a bit less pricey.  Anyhow, hope you are progressing well and enjoying your life more than ever, even with the new way of sleeping.  We count each day a gift wrapped up in sunshine, flowers and love from all our friends and family.   

Loretta - Wife of William, 14 yr. survivor, EC T3N1M0