Criteria You Must Meet
It should say that a scooter is medically necessary for use in your home, because you have limited mobility and meet all of the following criteria:
- you have a health condition that makes it extremely hard for you to get around within your own home
- you cant do daily living activities, such as using the bathroom, bathing, and dressing, even with a walker, cane, or crutches
- you can safely operate a mobilized device and are strong enough to sit up on it and use its controls
- you are able to get on and off the scooter safely: if not, you must always have someone with you who can assist you and ensure your safety
- your home can accommodate scooter use: for example, a scooter will fit in your bathroom, through your doors, and in hallways
You must go to a DME supplier who accepts Medicare. The approved seven-element order must be sent to your supplier within 45 days of your face-to-face doctors visit.
Get Coverage For Medicare
A licensed agent with Medicare Plan Finder may be able to help the best coverage to suit your needs, whether its a Medicare Supplement or Medicare Advantage plan.
There may be many plans available in your area, and your agent may be able to find a plan that fits your budget, lifestyle, and one that offers important benefits such as scooter coverage. To set up an appointment, call 833-438-3676 or contact us here today.
Medicare May Cover 80% Of The Cost Of A Mobility Scooter If Your Doctor Or Occupational Therapist Prescribes It
Medicare covers durable medical equipment, or DME, through Part B. This type of coverage is available for a variety of mobility aids and other equipment, but there are restrictions and limitations in place as well. Medicare will only cover equipment that has been deemed medically necessary, which means it is essential to your treatment and activities of daily living.
This article discusses how DME Medicare coverage works as well as guidelines you should be aware of as you seek coverage for any type of mobility product.
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Will Medicare Cover Your Handicapped Scooter
Medicare is a federally funded health insurance program for people over age 65 and those with certain disabilities or medical conditions. While the Social Security Administration enrolls people in Medicare, the Center for Medicare and Medicaid Services runs the program. The Medicare program has several parts and Medicare Part B is dedicated to durable medical equipment such as handicap scooters.
You must meet certain conditions under Medicare Part B for the program to consider fulfilling handicap scooters Medicare reimbursement. For example, you must have a necessary and reasonable need for a mobility device such as a handicapped scooter. Additionally, you must intend to use the mobility scooter primarily in your home and receive an in-person examination from your doctor. Medicare requires your doctor to give you a written prescription for a mobility device such as a scooter before you can receive one. Your doctor must also first consider the use of a cane, walker or manual wheelchair before considering a scooter. The medical need for the scooter must also be documented in your medical records. So, take that first step towards getting coverage for Medicare handicap scooters and schedule a face-to-face appointment with your regular physician.
What Part Of Medicare Covers A Mobility Scooter
There are four parts to Medicare:
- Part A covers inpatient hospital care
- Part B covers outpatient care, preventive services, emergency room visits, ambulance usage, and – most importantly here – medical devices
- Part C – also known as Medicare Advantage – is a managed care plan offered by private insurers that contract with Medicare to provide all Part A and Part B benefits
- Part D is the prescription drug benefit
Each of these parts has different coverage options and costs. A good visual overview can be seen here on YouTube.
Medicare’s Part B is most likely to cover of the cost of a motorized scooter. If youre not sure if you have Medicare Part B, contact your local social security office to ask.
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Conditions To Recieve A Wheelchair From Medicare
If you meet any of these conditions, then youve met the criteria to receive a wheelchair from Medicare:
- You must have Medicare Part B coverage.
- You must have a health condition that limits you and cannot do daily chores or activities like bathing, dressing or using the restroom with the use of a cane, crutch, or walker.
- You must be able to operate the equipment or have someone assist you in using the device safely.
Read Our Quick & Easy Guide To Qualify For A Medicare Scooter
IMPORTANT: Medicare says it will cover a scooter, but in reality, it’s much more difficult to get a scooter these days compared to getting a power chair. Medicare prefers to issue a power wheelchair because patients will normally move to a wheelchair from a scooter anyway. Years ago it was just as easy to get a scooter as it was a power chair. Sorry to say, but that’s all changed.
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Medical Scooters Through Medicaid
Medicaid is funded through a joint venture between state and federal governments. To qualify for Medicaid, an individual must fall within specific income and resource limits. Some of these qualifications vary by state, so its important to check with Medicaid reps where you live. Generally, Medicaid will only pay for a power mobility device, such as a medical mobility scooter, if the patient has a medical need for that device. Their doctor must also write a prescription. Learn more about obtaining a medical scooter through Medicaid.
How To Get A Free Mobility Scooter Through Medicaid
Many states use the Medicare payment rates when they cover mobility scooters. Many Medicaid recipients do not pay any costs for their medical coverage. Medicaid recipients cannot, however, just select a scooter that they want and hand over their Medicaid card for coverage. The provider, supplier, and physician must all accept Medicaid and be properly enrolled in the state program.
Are you a senior that receives Medicaid QMB? You may be able to get your scooter without cost if you do, since you do not pay deductibles, co-pays or other costs. Make sure that you give the physician, supplier and provider your Medicare card and your Medicaid QMB card.
You may qualify for this program if you are on Medicare and are income-eligible. The program, called Medicare Qualified Beneficiary, is administered through Medicaid. Many people that receive Medicare also receive Medicaid QMB benefits, which cover premiums, deductibles, and co-pays.
Contact Medicare to learn more about the program and you may be able to receive extra coverage, meaning that Medicaid pays for the costs of your scooter that is not covered by Medicare. The program does not cover benefits such as dental, vision, and hearing aid costs.
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How To Get A Wheelchair Through Medicare
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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.
Does Medicare Cover Stair Lifts
Stair lifts are a mobility aid many people use to travel up and down stairs in their homes. Medicare considers stair lifts to be home modifications rather than DME, therefore, Original Medicare doesnt cover them.
However, some Medicare Advantage plans may cover some of the costs of buying and installing a stair lift chair.
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How To Find An Approved Medicare Scooter Vendor
Medicare will only cover mobility scooters that are supplied by qualified durable medical equipment suppliers.
The supplier and your doctor will need to be enrolled in Medicare, but youll also need to ensure that the DME supplier is a participating vendor that will accept your assignment. In some regions of the country, you will need to secure a scooter through a Competitive Bidding Program, in which potential vendors submit bids for the lowest price.
We recommend that you search for vendors online. Make sure to read reviews before choosing a vendor and always get quotes from multiple vendors to compare prices. Once you’ve found a few potential DME suppliers, contact them to discuss your needs and see if they offer any discounts. With a little research, you should be able to find a vendor that meets your needs and budget.
While My Own Wheels is not a qualified Medicare or Medicaid provider, we offer a wide range of affordable mobility scooter options for those looking to make a purchase outside of these programs.
We also provide financing options to remove barriers to access and help you get back to living your best life, regardless of your budget.
Mobility Scooters Covered By Medicare
If youve been having trouble easily moving from place to place, a mobility scooter might be something you can benefit from. These scooters are designed to get seniors where they need to go, while preventing falls and keeping them stable. It can also encourage people to stay active, even if theyre losing their strength and physical abilities.
But if theyre a bit out of your price range, theres a chance Medicare could help. If you meet certain criteria, Medicare may cover the cost of a scooter. Thats why its important to see if your scooter could be covered under Medicare before shopping for one.
Heres what you need to know about Medicare covering the cost of mobility scooters.
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What Is A Mobility Scooter
Mobility scooters are three or four-wheeled vehicles that persons with limited mobility use to stay active and independent. They are designed to be used indoors and out and can be ridden for several miles without the battery dying.
Mobility scooters are powered by batteries and require no physical effort to use. They are an ideal mobility aid for people with severe limitations who cannot use other devices, such as canes and walkers. As a result, many seniors use them almost daily when they are out of the house, running errands, and spending time outside.
How To Get A Mobility Scooter Through Medicare
Steps to get Medicare Coverage for a Mobility Scooter
- Contact your doctor to discuss mobility aid options and make an appointment.
- Prepare a list of real examples that show exactly what ways a mobility scooter will help you achieve a typical lifestyle.
- Have a face-to-face consultation with your physician about mobility options. Medicare accepts in-person and virtual…
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Are You Making The Right Mobility Choice
If you have questions about finding the right power mobility device for your particular needs, talk to a Hoveround Mobility Specialist at 800-542-7236. Hoveround offers a complete selection of maneuverable power chairs, stylish mobility scooters and other mobility products to fulfill a variety of personal mobility needs.
1Insurance coverage depends on medical necessity as determined by insurer. Valid doctor’s prescription required. Hoveround currently does not take Medicare assignment on electric scooters and most other DME companies also do not accept Medicare assignment on scooters. Find more information about Medicare’s benefit for power scooters and power wheelchairs by visiting Medicare.gov.
This article is for informational and educational purposes only and is not intended to replace professional medical advice.
When Does Medicare Cover Mobility Scooters
Medicare Part B covers durable medical equipment, including scooters, if you have limited mobility and:
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You’re unable to perform daily tasks , even with the help of a walker, cane or crutches
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Your doctor and DME provider are both enrolled in Medicare
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The DME can be used in your home
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You can safely operate the scooter or have someone available to help you
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You can safely get on and off the scooter or have someone available to help you
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You have a health condition that makes it difficult to move around your home
If you are enrolled in Medicare Part A but not Part B , you will not have coverage for durable medical equipment and other medical expenses.
If you think that enrolling in Part B would benefit you, we recommend enrolling as soon as you are eligible . Although you may have the option to enroll in Part B later, you will likely pay a Part B late enrollment penalty.
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How To Find Mobility Scooters Covered By Medicare
There are a lot of ways to find Medicare-approved DME. As long as you have a written prescription from your doctor, then you can proceed with looking into scooters that are covered.
A scooter can help you travel where you need to go with ease. It can be an essential way to help make doing everyday tasks less painful and more convenient. Plus, there are plenty of different kinds to choose from that will meet your individual needs. You can find stores that sell Medicare-approved scooters in your area with a quick online search.
Before buying anything, make sure to read up on your healthcare coverage. Youll need to fully understand what Medicare will be paying and what you will be paying out of pocket. Its worth taking the time to research your healthcare plan once you realize how much more comfortably youll be living with a motorized scooter.
How Much Does Medicare Pay For A Scooter
Scooters, also called power-operated vehicles, are often covered by Medicare if you meet the requirements. But if you do qualify, how much does a motorized scooter cost? The answer depends on your needs scooters can range in price from hundreds to thousands of dollars.
Like wheelchairs and other durable medical equipment, scooters are covered at 80% by Medicare Part B. You will pay 20%. The Part B deductible will need to be met before Medicare will begin paying its portion for your mobility scooter. If you have Medicare Advantage, you may have different coverage and pricing if you need a mobility scooter.
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Choosing An Electric Scooter
If your evaluation has established that an electric scooter is the mobility product that best fits your requirements, you can begin to decide what type of scooter you need. There are many styles of scooters with a wide variety of options and accessories. All models of scooters have the same basic features. They have a seat on top of a wheeled platform and a column at the front with controls or hand-rests. The column is called the tiller. The base unit will offer support for your feet and contains the drive system and battery. Your doctor or therapist will have specific results that will help determine your choice. For instance, if you have less hand strength, that will mean that you would have difficulty using hand controls. Other types of controls are available.
The following are other factors to consider:
- Where will you use your scooter? Electric scooters are available in three- or four-wheeled models. If you will be using your scooter primarily outdoors, the four-wheeled model will offer more stability and is easier on rough terrain. The three-wheeled model works well inside since it is easier to maneuver in smaller spaces.
- Will you be taking your scooter with you in your vehicle? There are full-size electric scooters and portable scooters. The portable scooter can be folded and placed in a vehicle. This is good if you are still driving and dont want to purchase an additional scooter lift that is necessary for a full-size scooter.
Changes to Medicare Coverage for 2011
What Are The Basic Coverage Criteria For A Standard Wheelchair To Be Covered By Medicare
The records document that all of the following basic criteria are met: The beneficiary has a mobility limitation that significantly impairs his/her ability to participate in one or more mobility-related activities of daily living such as toileting, feeding, dressing, grooming, and bathing in customary
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Eligibility Criteria For Wheelchairs
A decision memorandum by the CMS concludes that the evidence is adequate to determine that wheelchairs in the decision memorandum) are reasonable and necessary for individuals who have a personal mobility deficit sufficient to impair their performance of mobility-related activities of daily living such as toileting, feeding, dressing, grooming, and bathing.
How Much Will Medicare Pay For A Mobility Scooter
Part B will pay 80 % of the Medicare-approved amount after the Part B deductible has been met. The Part B deductible is $233.
If you dont have a form of supplemental coverage, such as a Medigap or Medicare Advantage plan, youll be responsible for the remaining 20%.
A mobility scooter can cost anywhere between $600-$3,000 depending on the model. Having to pay 20% coinsurance can put a dent in your monthly budget.
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