Paying For Walkers For Seniors With Medicare Supplements And Medicare Advantage Plans
Medicare Supplement insurance plans may help pay some or all of your portion for walkers. They may make you acquire your equipment from contracted suppliers and at Medicare-approved cost amounts.
There are up to 10 Medicare Supplement insurance plans available, labeled A, B, C, D, F, G, K, L, M, and N. All these plans pay for Medicare Part P coinsurance for walkers at least 50%. Most Medicare Supplement insurance plans pay the Medicare Part B coinsurance for walkers 100%.
Note that the high-deductible version of Plan F has its own deductible that must be satisfied first.
You will need to review your Medicare Advantage plan to understand how it will cover durable medical equipment such as walkers for seniors. These plans vary, so they may have you pay a copay or some percentage of the cost.
Is coverage for walkers for seniors, other kinds of durable medical equipment, or another health issue very important to you? Enter your ZIP Code on this page to find a Medicare Supplement plan that can help cover your coinsurance for walkers for seniors.
New To Medicare?
Becoming eligible for Medicare can be daunting. But dont worry, were here to help you understand Medicare in 15 minutes or less.
What Equipment Does Medicaid Pay For
Medicaid covers a range of durable medical equipment however, the exact definition and list of covered equipment can vary from state to state. Most states define durable medical equipment as equipment that can withstand repeated use, is primarily used to serve a medical purpose, is appropriate for home use and is not useful to a person without illness or injury. In addition to walkers, equipment generally covered includes wheelchairs, hospital beds and home oxygen equipment.
In every state, Medicaid will only cover medically necessary equipment, which must be prescribed by a health care professional. Equipment covered by Medicaid must also be cost effective. In practice, this means that DME provided by Medicaid is normally a basic model.
If the equipment you need isnt covered by Medicaid, there are other options for obtaining walkers and other DME. You can buy equipment yourself. Many people find that buying from an internet store is a more affordable option. Some states also have DME programs that have loan closets where you can borrow equipment or refurbished equipment available at reasonable prices. There are also charities in many areas with similar programs.
When Does Medicare Cover Walkers
In order for Medicare to cover your walker, three requirements must be met:
- The walker must be considered medically necessaryMedical equipment is considered to be medically necessary by Medicare if the items are needed to diagnose or treat an illness, injury, condition, disease, or its symptoms. This determination must be made by a qualified health care provider.
- The walker must be prescribed by a doctorAs with prescription medication, a walker must be prescribed to you by a doctor in order for it to qualify for coverage by Medicare.
- The doctor and the walker supplier must accept Medicare assignmentIn order for a walker to be covered by Medicare, both the doctor writing the prescription and the supplier that is providing the walker must accept Medicare assignment.
Depending on the circumstances, you may be required to rent or buy the walker.
Read Also: Is Dme Covered By Medicare
How Does Medicare Coverage Work With A Wheelchair
Wheelchairs are considered durable medical equipment under Medicare guidelines. Other examples of DME for mobility include walkers, canes, power scooters, and power wheelchairs. In order to qualify for Part B Medicare coverage of your wheelchair or other mobility device, you must meet the following conditions:
- Your doctor must write an order indicating that you have a medical need for a wheelchair to get around in your home .
- You have a health condition that limits your mobility and makes it difficult for you to move around your home.
- You need a wheelchair to help you with daily activities of living such as going to the bathroom, bathing, dressing, getting in and out of bed.
- You are physically able to safely operate a wheelchair or you have someone in the home that is always available to help you use it safely.
- Both the doctor who orders the wheelchair and the supplier who provides it must participate in the Medicare program.
Must Obtain Prescription/written Authorization
In order for a rollator walker to be covered, it must be prescribed or cleared by a doctor after a face-to-face visit. Without that prescription, you will still be able to obtain a rollator walker, but you will have to pay out of pocket. The reason for this is to prevent fraud and to prevent potential budget issues that could arise.
If a doctors prescription were not required to get a rollator covered, it would become very easy to fraudulently receive free DME. That would allow people to steal someones information, receive the DME, and sell it for a profit. With a doctors prescription, however, this cannot happen. It may seem like yet another hurdle to clear, but it is a helpful one for all seniors.
Your doctor will examine your injury or other medical need and assess whether you could benefit from a rollator. This will almost always be a very easy assessment the doctor only needs to know that you risk falling without one. Once the doctor decides, they write you the prescription, and youre out the door!
Many times, the first two guidelines, medical purpose and prescription mandatory happen as a natural result of needing medical assistance. So, you should be able to obtain your rollator walker during the normal process of receiving care. Ideally, you will always know upon leaving the doctors office or discharge from the hospital whether or not your rollator will be covered!
Read Also: What Is A Medicare Special Needs Plan
Does The Medicare Advantage Program Cover Mobility Scooters
The Medicare Advantage program covers everything in the original cover with the exception of hospice cover that is still under part A. This means that the Medicare Advantage plan covers critical mobility devices like scooters if the patients meet the criteria mentioned above.
As noted earlier, most Medicare Advantage plans are provided by private insurance companies certified by Medicare. The private insurance companies can offer additional benefits to their members such as routine dental and vision care, and prescription drugs. In most cases, the private companies charge a low co-payment and deductibles, or waive them when a patient is purchasing durable medical equipment, for example scooters.
The benefits mentioned above are not available in all locations, and you should continue paying premiums stipulated in Part B of the Medicare cover in addition to any other charges. If you want to know more about mobility scooters and Medicare cover, talk to your healthcare provider or shoot Medicare a question from their official website or phone.
What Is Durable Medical Equipment
Walking aids fall under the category of durable medical equipment. They include crutches, canes, walkers, wheelchairs, scooters, and motorized wheelchairs.
To buy or rent durable medical equipment , Medicare recipients must use a DME supplier. That company must have enrolled with Medicare and agreed to Medicares reimbursement rates. Your prescribing doctor must also have done the same. Your doctor can help you find a nearby supplier and determine if buying or renting makes sense.2
Read Also: What Is Medicare In Simple Terms
How Often Are Walkers Covered By Medicare
If you qualify for Medicare coverage of your walker, Medicare will pay for the purchase or rental of your walker and will also pay to replace it anytime it is lost, stolen or damaged beyond repair in an accident or natural disaster.
Medicare will also pay for the repair or replacement of a walker if it is worn from everyday use and has been in your possession for the duration of its lifetime.
Which Is The Best Upright Walker
The Best Upright Walkers for Seniors Best Overall: ELENKER Upright Walker. This walker by ELENKER is one of the more reliable choices out there. Best Budget: Drive Medical 10257BL-1 Four Wheel Walker. Best Lightweight: Goplus Foldable Standard Walker. Best for Tall People: Drive Medical RTL0266-T Walker.
You May Like: Does Medicare Cover Smoking Cessation Products
Which Medicare Plans May Be Best For You If You Know You Need A Wheelchair
If you think youre going to need a wheelchair in 2020 and youre eligible for Medicare, you will need to decide which plan will best meet your needs.
Medicare Part A covers hospitalization. If you need a wheelchair during a hospital stay or while you are in a nursing home, the facility will provide you with one.
Medicare Part B covers medical services. Under Part B, wheelchairs are covered as durable medical equipment.
Medicare Part C is also called Medicare Advantage. Since Medicare Advantage plans are required to cover the same benefits as original Medicare , wheelchairs are covered under these plans. The specific benefits and requirements will vary from plan to plan.
Medicare Part D is prescription drug coverage. Even though you need a prescription or a doctors order to obtain a wheelchair, they are not covered under this part of Medicare.
Medigap are add-on plans to help you pay for costs that Medicare does not cover. Some Medigap plans could help you pay for some or all of the expense of a wheelchair.
Does Medicare Provide Alternative Coverage For Rollator Walkers
Some people with Medicare coverage upgrade to the Medicare Advantage plan for extra benefits that are not available under the original cover. Private insurance companies offer most of the benefits provided by the Medicare Advantage plan. This means that if you have an advantage plan you may qualify for additional benefits not granted under Part A and B of the Medicare plan that covers walkers. However, there is an eligibility requirement before you are granted the additional benefits.
Some of the additional benefits granted to people who meet the eligibility requirement include routine dental or vision care, prescription drugs, ear examinations and wellness programs. The original Medicare does not provide these benefits to people with mobility issues. You should note that Medicare Advantage plan vary by state and insurance company. This means that some of the benefits offered under the advantage plan are not available in all states.
To know the exact cost of your rollator walker, talk to your healthcare provider. The specific amount you will be charged is dictated by many things, which include the extra insurance you have, the amount your doctor charges, and the type of facility among others.
Recommended Reading: What Is My Deductible For Medicare
Does Medicare Cover Wheelchairs
Wheelchairs are covered as durable medical equipment under Medicare Part B. If your doctor prescribes a wheelchair for you to use in your home, then Medicare will cover 80 percent of the cost. That leaves you to pay 20 percent after your deductible has been met. Your doctor and supplier must be enrolled in Medicare for the equipment to be covered.
Medicare may pay only for you to rent a wheelchair not buy one because a wheelchair is a more expensive and substantial purchase than other common equipment. Medicare typically requires beneficiaries to rent and not purchase items that are considered DME.
But any repairs or replacement parts that you may need will be covered by Medicare only if you own the equipment, while costs for rented items will fall to the supplier. Medicare often pays for equipment like wheelchairs to be rented for up to 13 months.
If you are prescribed a wheelchair to use in your home, you may want to look into various home modifications that can prevent falls and accidents. Past studies have shown that these modifications lead to fewer injuries among wheelchair users.
How Much Do Wheelchairs And Walkers Cost With Medicare
The Medicare-approved amount is the amount that Medicare has declared it will pay the supplier in exchange for the item. The 20 percent share that you are responsible for is your Medicare Part B coinsurance.
Each supplier of durable medical equipment falls into one of three categories:
- If you receive the wheelchair or walker from a participating supplier, they must accept the Medicare-approved amount as full payment.
- If they are enrolled in Medicare but are not a participating provider, they have chosen to supply equipment to Medicare beneficiaries but do not accept the Medicare-approved amount as full payment. They can charge up to 15 percent more than the Medicare-approved amount, a cost that is known as an excess charge.
- If a supplier does not accept Medicare and are not enrolled in Medicare, the item will not be covered and there is no limit to what they may charge you.
You must meet your Part B deductible before Medicare will pay for your wheelchair or walker. In 2019, the annual Part B deductible is $185.
Medicare Part B also requires a monthly premium of $135.50 in 2019 .
The Part B deductible, coinsurance and excess charges may be covered by certain Medicare Supplement Insurance plans.
You May Like: Is A Walk In Tub Covered By Medicare
Are There Other Medicare Coverage Options For Medical Walkers
Some beneficiaries may decide to enroll in a Medicare Advantage plan to get at least the same level of Medicare benefits, while expanding coverage beyond Original Medicare. Medicare Advantage plans must cover everything included in Original Medicare coverage , but since these plans are offered through Medicare-approved private insurance companies, they may offer additional benefits not available under Part A and Part B.
Since Original Medicare covers medical walkers, youll also be covered for this durable medical equipment under a Medicare Advantage plan if you meet eligibility requirements. In addition, depending on the plan, you may have the opportunity to get coverage for routine vision or dental care, hearing, and/or prescription drug benefits. In addition, plan members may have access to benefits such as wellness programs. Under Original Medicare, these types of benefits arent covered. Medicare Advantage plans vary by state and insurance company, and not all plan benefits are available in all states.
Want to know more about how Medicare coverage can help with your mobility issues? I am happy to give you information and answer your questions. You can schedule a phone call or request an email by clicking on the buttons below. If you like, click on the View profile link to learn more about me. You can also find out about plan options in your area by clicking the Compare Plans button.
New To Medicare?
Types Of Walker With Seat
There are many brands of walkers with seat available. For Medicare patients we supply a Drive rollator walker with seat or a drive walker depending on what the patient wants. The walker with seat has a small extra upcharge fee. We prefer drive rollators over the hurryroll. They are better built for longevity.
The Drive medical walker comes complete with 4 large wheels, a seat, 2 brakes and a carry basket. They also come in different colors. We believe these to be the best walkers for seniors.
For patients paying out of pocket and not using insurance our best seller is the Drive medical nitro euro style rollator walker.
You May Like: What Is The Medicare G Plan
Does Medicare Pay For Upright Walker
Upright Walkers are a great way to maintain posture while providing support. This article answers the question: does Medicare pay for an Upright Walker and other questions.
Many readers ask us: does Medicare pay for an Upright Walker? We decided to investigate this question in detail.
An Upright Walker has immense benefits: most prominently, it helps you maintain a good posture, unlike regular walkers and rollators on which you have to hunch while walking. Hunching down on your walker, especially if you are using it regularly, can create big problems for your back.
There are many other benefits: they are lightweight, portable, and very easy to use. That is why many people are taking an interest in buying an Upright Walker. But the problem is that they are expensive and every elderly person cannot afford them.
This high cost is where the question arises: does Medicare pay for Upright Walker? Medicare normally covers walkers and rollators under its Durable Medical Equipment section for people above 65 years, the physically disabled, or those who have kidney problems in the final stages.
Considering the popularity of Upright Walkers, it would seem obvious that Medicare should cover them. In this article, I will discuss Upright Walkers in detail and answer this core question: does Medicare pay for Upright Walkers? But before we begin, let us talk a bit more about Upright Walkers and their benefits.
How Medicare Coverage Of Durable Medical Equipment Works
There are four basic requirements a piece of durable medical equipment must meet to qualify for Medicare coverage:
- The item is considered medically necessary
- The item is prescribed by a doctor
- The item is cost effective
- The doctor writing the prescription and the supplier of the item must be enrolled in Medicare
The UPWalker may be considered medically necessary and prescribed by a doctor. But with a retail price of more than $600 in 2021, which is several times higher than more traditional walkers, it may not meet the requirement of being cost effective.1
However, the main reason why the UPWalker is not covered by Medicare is because the supplier is not enrolled in Medicare, meaning they opt out of Medicare and dont accept Medicare reimbursement for their services or devices.
Suppliers of durable medical equipment and other health care providers have three options as it relates to Medicare participation.
Recommended Reading: Does Medicare Medicaid Cover Assisted Living