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The rules say that plans must pay for a medical service or item if regular Medicare would pay for it in this case. 
You can find this rule at 42 Code of Federal Regulations (CFR) Section 422.101. 
 
The rules say that a fixed height hospital bed (E0250, E0251, E0290, E0291, and E0328) is covered if one or 
more of the following criteria (1-4) are met: 
 
    1. The beneficiary has a medical condition which requires positioning of the body in ways not feasible with 
an ordinary bed. Elevation of the head/upper body less than 30 degrees does not usually require the use of a 
hospital bed, or 
    2. The beneficiary requires positioning of the body in ways not feasible with an ordinary bed in order to 
alleviate pain, or 
    3. The beneficiary requires the head of the bed to be elevated more than 30 degrees most of the time due to 
congestive heart failure, chronic pulmonary disease, or problems with aspiration, or 
    4. The beneficiary requires traction equipment, which can only be attached to a hospital bed. 
 
A heavy duty extra wide hospital bed (E0301, E0303) is covered if the beneficiary meets one of the criteria for 
a fixed height hospital bed and the beneficiary's weight is more than 350 pounds, but does not exceed 600 
pounds. 
 
You can find this information in the Local Coverage Determination (LCD) for Hospital Beds And Accessories 
(L33820). 
 
The rules say that for purposes of rental and purchase of durable medical equipment (DME) a beneficiarys 
home may be his/her own dwelling, an apartment, a relatives home, a home for the aged, or some other type of 
institution (such as an assisted living facility, or an intermediate care facility for  individuals with intellectual 
disabilities (ICF/IID)). However, an institution may not be considered a beneficiarys home if it: 
     Meets at least the basic requirement (see Section 1861(e)(1) of the Social Security Act (the Act)) in the 
definition of a hospital, i.e., it is primarily engaged in providing by or under the supervision of physicians, to 
inpatients, diagnostic and therapeutic services for medical diagnosis, treatment, and care of injured, disabled, 
and sick persons, or rehabilitation services for the rehabilitation of injured, disabled, or sick persons; or 
     Meets at least the basic requirement (see Section 1819(a)(1) of the Act) in the definition of a skilled nursing 
facility, i.e., it is primarily engaged in providing to inpatients skilled nursing care and related services for 
patients who require medical or nursing care, or rehabilitation services for the rehabilitation of injured, 
disabled, or sick persons. 
 
 Thus, if an individual is a patient in an institution or distinct part of an institution which provides the services 
described in the bullets above, the individual is not entitled to have  separate Part B payment made for rental or 
purchase of DME. This is because such an institution may not be considered the individuals home (see Section 
1861(s)(6) and 1861(n) of the Act, the implementing regulations at 42 CFR 410.38(b), and Section 2160B in 
the State Operations Manual (SOM, Pub. 100-07), Chapter 2).   
 
You can find these rules in the Centers for Medicare and Medicaid Services, Internet Only Manual, Publication 
100-02, Medicare Benefit Policy Manual, Chapter 15, Section 110.1(D). 
 
If you want to read these Medicare rules, you can go to this website www.medicareappeal.com.