Coverage for Lifts or Hoists under the Miscellaneous Expense Benefit
August 29, 2019
The PSHCP provides coverage for lifts or hoists, in certain circumstances. Lifts or hoists are equipment used to transfer a patient in and out of bed or from the bedroom to the bathroom as medically necessary. The Plan covers 80% of the reasonable and customary expenses for the purchase or rental of an eligible lift or hoist if it is:
- Manufactured specifically for medical use;
- For use in the patient’s private residence;
- Approved by the Administrator for cost effectiveness and clinical value; and,
- Designated as medically necessary.
Only one purchase can be reimbursed per covered person under the Plan, per lifetime. The PSHCP also covers 80% of the costs of repairs for a lift or hoist if its original purchase was not claimed under the Plan. Any amount previously paid for repairs will be deducted from the amount eligible for reimbursement if a member purchases a new lift or hoist.
The Plan does not consider costs for equipment such as stair lifts, lift chairs, stationary bath lifts, car lifts, and platform lifts, as these do not meet the requirements stated above.