How Advantage Plans Slow-Walk Lift Chair Approvals

For many Medicare Advantage members, the chair is ready long before the plan's approval is.

If you're waiting on a lift chair through a Medicare Advantage plan, the delay can start to feel personal. It usually isn't. It can help to ask your supplier one plain question first: has the request gone to your plan yet, and on what date?

Home care runs into the same wall. In 2024, 90% of Advantage enrollees were in a plan that required prior authorization for home health care. A 2025 study that interviewed 44 leaders from Advantage plans, post-acute management companies and home health agencies found that agencies say these reviews change access to care, how care is delivered and what patients go through.

Our plan data for Texas shows why one insurer's habits matter so much. In 2024, UnitedHealthcare held 50% of the state's Advantage members and Humana held 27%. When two companies cover that many people, their review rules become the rules most Texas families live with.

I think you should know that before the first form goes out. The extra days begin with what Medicare itself asks for, and that list is longer than most people expect.

Why does a Medicare Advantage lift chair take longer than Original Medicare?

In 2024, 99% of Medicare Advantage enrollees were in plans that used prior authorization, a plan review step that Original Medicare's seat lift rules do not include.

A 2025 study in Health Affairs Scholar, led by Kali Thomas of Johns Hopkins, reported that figure and found that both plan leaders and home health agencies describe prior authorization as burdensome. Prior authorization means the plan reviews and approves an item before anyone delivers it. For a lift chair, that review sits between your doctor's order and your living room.

If you are waiting on a lift chair right now, it can help to check these things first:

1. Confirm whether you have a Medicare Advantage plan or Original Medicare. Your plan card usually shows this.
2. Ask the supplier whether your plan requires prior authorization for the seat lift mechanism, the motor that raises the chair.
3. Ask your doctor's office to send the visit notes and the written order together, in one packet.
4. Write down the date the request went in, so you can track how long the plan takes.

The common assumption is that a prescription is enough to get the chair delivered. With an Advantage plan, it often is not. The same order goes to the plan for review first, and the supplier generally waits for that answer before anything ships to your home.

Why can this review stretch so long? Part of the answer is scale, and part is incentive. A 2024 report from the U.S. Senate Permanent Subcommittee on Investigations, built on more than 280,000 pages of insurer documents, found that UnitedHealthcare, CVS and Humana together cover nearly 60 percent of all Advantage enrollees. It also found that in 2022, Humana denied post-acute care requests at a rate over 16 times higher than its overall denial rate.

Those findings are about nursing and rehabilitation care, not lift chairs. Still, they show how plans can treat costly categories differently. A review of 4 sources here, including our own plan data, points to one pattern: the extra review touches a large share of Medicare households.

Our own plan data shows how far that reach goes. In West Virginia, about 54% of Medicare beneficiaries were in Medicare Advantage in 2024, and about 67% of those members were with an insurer Understood Care accepts. In Massachusetts, the Advantage share was smaller, about 36% in 2025, yet about 81% of those members were with an insurer we accept. So the extra step is not rare. For many families, it is simply the normal path.

The approval step is only half the picture, since Medicare pays toward the motor and not the whole chair. Our guide on why "Medicare pays 80%" misleads lift chair buyers walks through that math. Here, the focus stays on the clock, and on where the first delay can start.

Where do the repeated documentation requests come from?

Repeat requests often trace back to the doctor's notes. Plans want proof that each Medicare seat lift rule was met, and a thin chart invites another round of questions.

It's common to feel like the plan keeps moving the goalposts. It can help to hold each new request up against the list below. The CMS coverage rule for seat lifts, LCD L33801, says a seat lift mechanism qualifies only when all four of these are true:

1. You have severe arthritis of the hip or knee, or a severe neuromuscular disease (a disease of the nerves and muscles).
2. The lift is part of your treating practitioner's plan to improve your condition or slow its decline.
3. You are completely unable to stand up from a regular armchair or any chair in your home.
4. Once standing, you can walk.

The rule adds one more line that is easy to overlook. Your practitioner's record has to show that other treatments, such as medication and physical therapy, were tried first and did not help you stand. Without that note, a reviewer has a reason to ask again.

Rehab hospitals have measured what extra paperwork does to the clock. In a 2022 survey by the American Medical Rehabilitation Providers Association covering more than 12,000 authorization requests, 39% of requests needed extra effort, such as additional documentation or a doctor-to-doctor call. In that 2022 survey, only 28.94% of those cases were finally approved.

Those numbers come from rehab admissions, not equipment. Still, the lesson carries over. Ask the plan to put each new request in writing. A second request does not promise a better answer.

One step can put your limits on paper before the plan asks: Medicare Part B will, "in most cases," pay for a physical or occupational therapist's mobility evaluation, physical therapist Tony Marado explained in 2024. Ask your doctor whether that evaluation is already in your chart before the request goes in.

To be fair, not every plan works this way. An industry group noted in 2022 that one-fifth of Advantage members were in plans that required no prior authorization for any service. Your own plan's rules are what count.

In Texas, our plan data shows about 54% of Medicare beneficiaries were in Medicare Advantage in 2024, and about 94% of those members were with an insurer we accept. If you are weighing outside help, our roundup of patient advocate services for Medicare Advantage plans compares the kinds of support available. Most families then ask something simpler: how long is the plan allowed to take?

How much longer do Medicare Advantage members wait for approvals?

Advantage members are noticeably more likely to wait on an approval than people in Original Medicare. The research section above walks through why.

A 2024 survey reported by Becker's Payer Issues asked 3,280 adults with Medicare about getting care. In 2024, 22% of Advantage enrollees said they waited for care because it needed approval, compared with 13% in traditional Medicare. Other measures were close. In that 2024 survey, about 1 in 3 people in each group waited more than a month to see a physician, and 65% in both groups said their coverage fully met their expectations.

That last detail matters to me. The gap is not about doctors or appointments. It is about the approval step itself.

Equipment sits right inside that step. Durable medical equipment means reusable items used at home, and seat lifts fall in that group. A study in the American Journal of Managed Care found that in 2019, 72.2% of Advantage enrollees faced prior authorization for durable medical equipment, the highest share among the service categories it measured. The same study found most categories required prior authorization more often as the years went on.

The number of people affected keeps growing. By 2024, 54% of Medicare beneficiaries were in Medicare Advantage, the highest share ever, and the average beneficiary could choose among 43 plans. Each plan sets its own review process. So two neighbors with the same diagnosis may wait very different lengths of time.

I want to be fair about the trade-off here. In that same 2024 survey, seven out of 10 Advantage enrollees used at least one supplemental benefit, and those extras are real help for many households. Before you enroll, it can help to ask a plan whether seat lifts need prior authorization and which papers it wants with the request. If you are weighing that choice during open enrollment, our look at whether a grocery card is worth leaving Original Medicare walks through it gently.

There is some movement on the plan side. A number of plans have signed commitments to make prior authorization easier for providers, and some have waived it for routine services. Whether seat lifts end up on those lists is not yet clear.

So here is what I would trust. Expect the review. Plan for it from the first doctor visit. Send a complete packet once, and write down the date it went in, because if a denial still arrives, your appeal clock starts with the date printed on that notice.

What should you expect from a lift chair approval going forward?

In short: Expect the plan review to stay, and expect paperwork to be the usual sticking point.

Expect the plan review to stay, and expect paperwork to be the usual sticking point. A complete packet from your doctor and supplier is often the surest way to save time.

Medicare's own seat lift policy, LCD L33801, hints at why. In 2022, federal improper payment data put the error rate for medical equipment claims at 25.2%. The policy's 2023 revision then added new claim modifiers meant to prevent improper payments. My read is simple. When Medicare tightens its checks on equipment, Advantage plans rarely loosen theirs.

There is still a gap. Plans rarely say up front which paper they will want next, so when a request comes back, you can ask the plan to name the exact document it still needs. Either way, it can help to treat every request as a chance to send the whole file at once.

We confirm each person's coverage before the first appointment, and the same habit works for your chair: the four criteria, the doctor's note on therapies already tried, and a signed order in the supplier's hands before delivery.