Are Wheelchairs Under Medicares Competitive Bidding Program
The Medicare program implemented a cost-saving measure known as the competitive bidding program which applies to certain types of durable medical equipment. Wheelchairs, along with items such as hospital beds and bedside commodes, are included in the program.
If you live in certain areas of the country covered by the competitive bidding program, you will need to get your wheelchair from an approved supplier. If you dont, Medicare may refuse to cover any costs associated with your wheelchair or power scooter.
Note that the competitive bidding program was temporarily suspended on December 31, 2018, and is not expected to be reinstated until January 2021.
Medicare Advantage Plans Can Cover Wheelchairs Walkers And Wheelchair Ramps
While wheelchair ramps are not covered by Original Medicare , they may be covered by certain Medicare Advantage plans .
A Medicare Advantage plans provides all the same basic benefits as Original Medicare, which means that Medicare Advantage plans cover wheelchairs and walkers the same way that Original Medicare does.
Most Medicare Advantage plans also offer additional benefits not covered by Original Medicare. Starting in 2019, a set of additional benefits approved for coverage by Medicare Advantage plans may include a number of aging in place items, such as home wheelchair ramps and bathroom grab bars. Check plan benefits to see if these services or items may be covered.
To learn more about Medicare Advantage plans and to compare plans in your area, call to speak with a licensed insurance agent today.
Or call 1-800-557-6059TTY Users: 711 to speak with a licensed insurance agent. We accept calls 24/7!
About the author
Christian Worstell is a licensed insurance agent and a Senior Staff Writer for MedicareAdvantage.com. He is passionate about helping people navigate the complexities of Medicare and understand their coverage options.
His work has been featured in outlets such as Vox, MSN, and The Washington Post, and he is a frequent contributor to health care and finance blogs.
Christian is a graduate of Shippensburg University with a bachelors degree in journalism. He currently lives in Raleigh, NC.
Where you’ve seen coverage of Christian’s research and reports:
Manual Vs Power Wheelchair Or Scooter
If you have sufficient upper body strength or a helper, you could qualify for a manual wheelchair.
If you cant use a manual wheelchair, you may get coverage for a power wheelchair or scooter. To qualify, you must have an in-person exam with your doctor. If the doctor believes you require a power mobility device, they will submit an order to Medicare recommending the wheelchair or scooter and stating that youre able to operate it.
Don’t Miss: Does Medicare Cover Ambulance Transport
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.
How Can I Get A Wheelchair For Free
If your mobility has been compromised due to age, an injury, or a recent disability, you would need a wheelchair to help you get around.
However, an electric chair or even a manual one may be expensive to acquire.
Modern wheelchairs are not cheap and sometimes you may need to pay as much as a months salary just to get a high-quality wheelchair that you can rely on.
According to statistics published by the Knights of Columbus, about 100 million people with disabilities across the world simply cannot afford this.
Luckily, there are so many programs and charities that are committed to providing the gift of mobility by providing free wheelchairs as well as free mobility scooter to those who need them most.
If you fall into this category, there are several ways you can get a free chair or rather at a subsidized price to improve your quality of life.
You May Like: When Can I Get My Medicare
Free Wheelchair For Seniors And The Disabled Programs
Many communities offer a free wheelchair scheme for seniors and mobility impaired individuals who cannot afford to buy one. These programs are usually run by local charities or church organisations. They use money from fundraising drives to buy wheelchairs and give them to those in need of support.
Word of mouth is a good way to find out about these programs. If youre part of any local support groups or forums, ask around. You may be surprised at the amount of assistance thats available to you. Of course, you can also use the internet to research free wheelchair programs in your town or city.
How Can I Get A Free Electric Wheelchair
You may be entitled to a free electric wheelchair if you are a Medicaid enrollee and your state covers it. You may also receive funding for most of the cost of your electric wheelchair if you’re a Medicare beneficiary and it’s a safe and necessary option. Some private health care insurance plans also cover electric wheelchairs.
If you’re ineligible for an electric wheelchair through Medicaid, Medicare or your private insurer, you may be able to get a free electric wheelchair through a nonprofit organization. Several regional organizations provide subsidized or free refurbished wheelchairs to local people in need. Your doctor or a local support group or forum can help you find a local organization that provides donated wheelchairs to people who need them.
Read Also: Is Medicare Available For Green Card Holders
How To Get A Power Wheelchair Or Scooter Through Medicare:
Please refer to the Medicare Competitive Bidding Program information at the top of our Medicare Frequently Asked Questions page. This page provides detailed information on locating a supplier in your area approved by Medicare to supply and bill for equipment. This Competitive Bidding Program means you must use a supplier by patient postal zip code.
Shortcut to locating a local Medicare approved Supplier: Medicare Supplier Directory
Beneficiary Complaint Hotline:*** Phone number for beneficiary complaints: 404-8702 The phone number above is to live operators and is staffed 24/7. Use this number if you are unhappy with the lack of service and quality equipment you receive resulting from the Medicare bidding policy.Questions for Medicare:
Will Medicare Or Medicaid Pay For My Power Wheelchair
If youre receiving coverage by Medicare/Medicaid, you can get coverage for a power wheelchair however, there are a few points to consider. First, you must contact your doctor and obtain a note or prescription from your doctor explaining that you need a wheelchair to get around the house. The doctors visit must take place within 45 days of the time that you place your order from a dealer that is contracted by Medicare or Medicaid in order to receive coverage. To see the most up-to-date regarding Manual Wheelchairs & Power Mobility Devices being covered with Medicare, visit the Medicare.gov official website.
Read Also: What Does Medicare Part B Cover
What Other Mobility Equipment Is Covered By Medicare
Wheelchairs and walkers are not the only items designed to help with mobility that are covered by Medicare. Similar items that may qualify as durable medical equipment and can be covered by Medicare include:
- Therapeutic shoes or inserts for people with severe diabetic foot disease
- Prosthetic legs
- Leg braces
To Get A Wheelchair You Must Satisfy Several Conditions
Your wheelchair or scooter will be covered only if your doctor and your equipment supplier are enrolled in Medicare.
Medicare will pay most of the cost of your wheelchair or scooter if all of these conditions are met:
Your doctor submits an order stating your medical need for a wheelchair or scooter.
You have a health condition that makes it difficult for you to move around your home.
You cant do activities of daily living such as getting out of bed and bathing with a cane or walker.
Youre able to safely use a wheelchair or scooter on your own, or you always have someone available to assist.
The layout of your home will accommodate a wheelchair.
Also Check: Will Medicare Cover Cataract Surgery
Two Things To Do If You Or Someone You Know Needs A Wheelchair From Medicare
Wheelchairs can cost a crazy amount of money, anywhere from $500 to $6000. Fortunately, Medicare will pay for a manualor motorized wheelchair if you meet the coverage conditions, and a doctor prescribes one. If you think you or someone you love needs a wheelchair, here are the two steps you need to take:
1. What you need from your doctor:
- You must see your doctor and the doctor must prescribe a wheelchair for you.
- The doctor must explain in writing that you need the wheelchair to get around in your home, that a walker or cane will not give you the mobility you need.
- If the doctor is prescribing a power wheelchair or scooter, you must not be able to use a manual wheelchair.
- Whether a manual or a power wheelchair, the doctor must describe the reason you need the wheelchairfor example, you have difficulty getting out of bed, getting dressed, going to the bathroom and performing other activities of daily living. The doctor also must state that you are able to use the wheelchair on your own or with assistance from someone who will be with you in your home.
2. Where to get your wheelchair
- If you have traditional Medicare, you must get the wheelchair from a Medicare contract supplier. Call Medicare at 1-800-633-4227 to find out where to go for your wheelchair. Or you can visit the Medicare.gov web site.
- If you are enrolled in a Medicare HMO or other private Medicare plan, call the plan and follow the plans rules.
Heres more from Just Care:
Assessment Of Your Medical Needs
You must address specific questions in your face-to-face interview with a healthcare provider. Specifically, you or your caregiver must answer:
- What is your mobility challenge and how does it interfere with your daily activities?
- Why cant a cane or walker handle your mobility needs?
- Why cant a manual wheelchair be used to meet your mobility needs?
- Are you capable of transferring to and from the PMD and operating it safely within your home?
- Do you have the physical and mental capacity to operate the PMD by yourself?
You May Like: What Is A Medicare Wellness Checkup
What Are The Out
Medicare Part B pays 80 percent of the cost of a wheelchair after you have met your annual deductible. You will pay 20 percent of the cost in addition to your annual Medicare premiums. You may also have copay costs associated with any doctor visits necessary to get your wheelchair.
In some parts of the country, DME suppliers are required to participate in a competitive bidding program, which helps to keep costs manageable. However, that competitive bidding program has been temporarily paused until January 1, 2021.
During this temporary gap, it is especially important to be aware of aggressive marketing techniques practiced by some DME suppliers. If you have any questions or concerns about a DME supplier, or about someone who has come to your home to try to sell you DME, you can call the Fraud Hotline of the HHS Office of Inspector General at 1-800-HHS-TIPS or report it online.
How To Get A Wheelchair Through Medicare
wikiHow is a wiki, similar to Wikipedia, which means that many of our articles are co-written by multiple authors. To create this article, 9 people, some anonymous, worked to edit and improve it over time.wikiHow marks an article as reader-approved once it receives enough positive feedback. This article received 12 testimonials and 87% of readers who voted found it helpful, earning it our reader-approved status. This article has been viewed 180,551 times.Learn more…
If you are on Medicare and you have suffered from a recent injury or disability, or are recovering from surgery, you might be eligible for a wheelchair benefit. Older people who find their mobility has been compromised can also try to get a wheelchair with their Medicare Part B benefits. It does not take much to get a wheelchair from Medicare, just talking to a doctor and finding the right supplier.
What Will My Out
Also, depending on where you live, your equipment may be subject to Medicares competitive bidding program. If you live in an area where this applies, you must get your scooter from a vendor contracted with Medicare under the competitive bidding program. This can help lower the costs.
Before picking a supplier, make sure that the supplier, as well as your doctor, are both currently participating in Medicare. Then discuss your payment options and whether you should purchase or rent the wheelchair from the supplier.
Make your decision based on the length of time you will need the device. Part B only pays for a portion of the total cost on your device. Meaning there will be 20% of that cost left for you to pay, out of pocket.
How To Get A Power Wheelchair Funded By Medicare
Inevitably, age and illness will affect us all. When they do, a powered wheelchair or mobility scooter can return precious mobility to those who have lost the power of ambulation. Whether youre looking to obtain a power wheelchair for yourself or a loved one, here is the process youll have to go through.
Medicare is designed to provide health insurance to persons aged 65 and over and those with disabilities. The program has several parts. Part B pays for Durable Medical Equipment , such as a power wheelchair or mobility scooter.
The first step to obtaining a power wheelchair covered by Medicare is to have an in-person assessment of the recipients health by a qualified medical provider. If the recipient is considered eligible for coverage, Medicare will cover 80% of the cost of the chair. The price and type of chair will depend on the needs of the patient.
Mobility scooters usually cost between $800 and $1,000, and an electric folding wheelchair, powered wheelchair, or motorized wheelchair can cost between $2,000 and $15,000. The recipient will be required to pay a Part B deductible that should run between $150 and $200. He or she will also need to pay the remaining 20% of the cost of the chair.
Don’t Miss: How Do I Apply For Medicare In Ohio
Lets Break Down How To Get A Wheelchair
Unless you have the money to pay for your wheelchair out of pocket, youll need to use alternative methods. Luckily for you, there are plenty of free programs you can access to buy one that meets all of your needs.
First, before we get into all of the cost-free ways you can obtain a wheelchair, lets talk about one of the most well-known methods, which is medicare part B. Medicare Part B covers the majority percentage of the costs of electric chairs. Before you can receive your wheelchair, youll need to set an appointment to determine eligibility.
To be eligible for a wheelchair through medicare Plan B, you must meet the following requirements:
- Limited mobility
- Youre able to operate your wheelchair safely with or without assistance
- You cant perform daily activities necessary to live a normal life like dressing, bathing, using the bathroom, or to get in & out of bed
Meet any of the above qualifications. Youll likely be able to acquire a chair through your medicare Part b insurance coverage. If you dont have Medicare Part B insurance, there are other options available.
Here are some alternative ways you can obtain a wheelchair at little to no cost:
These are some of the most sure-fire ways to obtain a wheelchair if you have limited insurance coverage.
How Medicare Covers Electric Wheelchairs
If Medicare approves your electric wheelchair, Medicare Part B will cover 80% of the Medicare-approved amount for the wheelchair after your annual deductible is met. Your responsibility is 20% of the cost of the wheelchair unless you have a Medigap plan that covers the Part B coinsurance for you. A secondary insurance generally covers some or all of the costs above the Medicare-approved amount.
A Redman Power Chair is a complex rehabilitation chair. Specifically it is a multi-option group 3 power wheel chair and it is the only power chair that is purchased via Medicare. All other power chairs are capped rental under Medicare guidelines. Note that Medicare will require you to have a face to face encounter with your physician who writes a prescription for the wheelchair.
Also Check: Can A 60 Year Old Get Medicare
Shopping For Power Wheelchairs Covered By Medicare
There can be a lot of questions when shopping for an electric wheelchair. In addition to wanting information on Medicare-approved power wheelchairs, you may also have questions about how fast motorized wheelchairs can go, can they get wet, and how much do they weigh.
There are several factors that can determine power wheelchair speed. The average wheelchair will go up to 4 mph, but there are some that have faster speeds. The weight of the user and the terrain are two main factors if the wheelchair can go faster.
When it comes to moisture, its always best to avoid getting your electric wheelchair wet, but sometimes it can be unavoidable. What matters is what you do after any contact with water, to preserve the performance and life of the wheelchair.
When it comes to the weight of a power wheelchair, some electric wheelchairs are designed to be more lightweight and portable, so they are built with lighter materials. One wheelchair can weigh 53 pounds without batteries, while another can weigh 195 pounds because it is designed to be heavier to support larger weight capacities.