Reimbursement & Funding Guidelines For Special Needs Beds
Many families have succeeded in receiving funding from private insurance, Medicaid, Medicaid Waivers, or charities for special needs beds. Typically, enclosed beds are covered for repeated safety concerns such as elopement, seizures, or self-injurious behavior. The sensory and monitoring benefits that a Boogaloo provides are an added bonus but should be focused on less than the safety needs.
Have further questions? We'd love to help! Please reach out using the Contact Us page :)
Medicaid / Private Insurance
Generally, insurance will only cover a Boogaloo for significant safety concerns such as seizures, elopement, headbanging, or other well documented behaviors that could cause injury. Although we can’t guarantee that your insurance will cover a Boogaloo, we will work with you to help as much as we can.
Here are the steps:
1 - Collect & Create Documentation
You will need the following:
- Diagnostic letter and a prescription for a Boogaloo Safety Bed from your Physician. The prescription should be for a “Boogaloo Safety Bed”.
- Letter of medical necessity from your occupational therapist or doctor (or both!). We recommend making the process easier for your doctor or OT by writing your own letter of medical necessity that they can then edit and sign off on. The Letter of Medical Necessity will need to focus on safety concerns (elopes, requires padding, entrapment risk, needs a sensory controlled environment to soothe, constant video monitoring, etc). You will also want to include what you have tried or are currently trying to help (medications, locks, other beds, video monitoring, etc). This will alert insurance to the possibility that this bed could be a last resort for their safety. Having repeated medical history of safety issues and photo or video documentation is helpful in getting funding.
2 - Work With Medical Equipment Supplier To Submit Docs
We have partners that supply medical equipment across the nation. They can help you refine your documents and submit for reimbursement. Contact us with your zip code and we would be happy to introduce you to a supplier in your area. If you have a favorite supplier, ask them to contact us and we can set them up as a distributor.
3 -Be Prepared For A Denial
This will vary by your insurance coverage and situation but many families are denied the first time they try to get a special needs bed reimbursed. This is very common. Don’t give up… It’s time to rally the troops!
Write a letter of appeal (and have your doc write one too!) addressing the denial notes. Provide counter-evidence such as photographs, videos, or accurate descriptions of incidents such as their limbs getting caught in bed rails or falls. If available, include more medical records such as injuries, skin breakdown, or sleep problems.
We are rooting for you! And here every step of the way if you have questions.
If you are ultimately denied, it's not the end. There are other options like charities, grants and low interest financing that can help.
5 - Enjoy Your Boogaloo Bed!
Insurance Reimbursement Codes
- E1399 - Misc DME Code - most commonly used
- E0328 - Ped hospital bed, manual
ICD-10-CM codes (Diagnosis Codes)
- Autism or Pervasive developmental disorder F84.0
- Intellectual disabilities F70-F79
- Down Syndrome Q90
- Cerebral Palsy G80
- Angelman Syndrome Q93.51
- Wandering Z91.83
The funding pathway is different for every waiver so talk to your case manager about the process. They can contact us with questions. If you’re not yet on a waiver, these are excellent programs to provide financial resources for your loved one. Typically, your child qualifies solely based on their income which means most children with disabilities will qualify. You can find out more information here- www.medicaidwaiver.org
Foundations & Grant Programs
Click here for a great list of resources
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