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.
Controllers For Power Wheelchairs
The term controller describes the electronics that connect the interface to the motor and gears in the power wheelchair base.
Electronic connections between wheelchair controllers and power seating system motors describe the electronic components that allow the user to control two or more of the following motors from a single interface : power wheelchair drive, power tilt, power recline, power shear reduction, power leg elevation, power seat elevation, power standing. It includes a function selection switch which allows the user to select the motor that is being controlled and an indicator feature to visually show which function has been selected. When the wheelchair drive function has been selected, the indicator feature may also show the direction that has been selected . This indicator feature may be in a separate display box or may be integrated into the wheelchair interface. It includes the fixed mounting hardware for the control box and for the display box .
Available Medicaid Mobility Scooters
There are numerous benefits of Medicaid mobility scooters. if you meet Medicaid requirements, the right electric scooter, such as the Victory® 10.2 Mobility Scooter, can help you maintain your independence and mobility. The exclusive one-hand touch disassembly makes it easy to transport your scooter from one place to the next. Non-scuffing tires spare your floors from marks. Frosted LED headlights give you visibility for enhanced safety. Some other great features of this Medicaid mobility scooter include a USB charging port to power your cell phone, as well as an integrated storage space with cupholder in the tiller.
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Medicare Coverage For Scooters
The business of providing medical equipment to Medicare patients brings in a lot of money every year to companies all over the country. The problem is that some of these companies develop television commercials that make it look like it is very easy to get important equipment such as electric scooters. These commercials also make it look like the supplier is the place where the approval process starts for getting an electric scooter. Medicare patients need to be very careful when watching commercials like this because they are a little misleading. Any kind of medical expense that is covered by Medicare begins with your doctor and not with a phone call to a supply company’s convenient toll free number.
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.
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How Do I Get A Wheelchair From Medicare
Like other durable medical equipment, Medicare will help cover a wheelchair if you meet certain conditions. To qualify for Medicare wheelchair coverage, you must meet all of the following requirements:
- Your doctor must state in writing that a wheelchair is medically necessary
- You have a medical condition that makes it significantly challenging to get around your home
- Your treating physician and wheelchair supplier are both enrolled in Medicare
- Youre unable to perform activities of daily living such as dressing, bathing, using the restroom, or getting in and out of bed or chairs with the help of a walker, cane or crutches.
- You can safely use the equipment in your home
If you meet all of these requirements, Part B may help cover the cost of a wheelchair. Original Medicare members can add Medicare Supplement Insurance , which can help cover the Part B deductible and copays you need to pay for your wheelchair.
If you have Medicare Advantage , you receive the same level of coverage. Many Part C plans offer additional benefits and may have different pricing for medically necessary wheelchairs.
Steering And Handling Ability
Electric mobility scooters are steered by handlebars and operated through controls located on the vehicle’s tiller. This type of set up works well for an individual with enough upper body strength, arm reach and range of motion to manage the power scooter safely. For others, a power chair might be a better solution.
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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.
Drive Medical Ventura 4
The Drive Medical Ventura 4 has four-wheels with an ergonomic throttle control. It has a large carrying basket at the front and padded armrests. A headlight and anti-tip wheels are added safety features to help you feel more at ease while operating. Theres also interchangeable color panels so the owner can choose between a red or blue scooter.
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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.
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.
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How To Get A Mobility Scooter Covered By Medicare
Please note that Parentgiving does not accept Medicare. This article explains how, if you qualify for Medicare Part B, Medicare can help pay for the cost of a scooter.Lets face itthe older we get the harder it becomes to move around. If youre a senior and you suffer from mobility issues you may qualify for a scooter if you meet the right requirements.
What Steps Do I Need To Take
Keep these facts in mind as you consider the steps you need to take when considering a scooter for mobility
- Medicare Part B covers power-operated vehicles and manual wheelchairs as durable medical equipment that your doctor prescribes for use in your home.
- You must have a face-to-face examination and a written prescription from a doctor or other treating provider before Medicare helps pay for a power wheelchair.
- Power wheelchairs are covered only when theyre medically necessary.
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Criteria For Specific Types Of Power Wheelchairs
A Group 2 Single Power Option PWC is considered not medically necessary if criterion II or II is not met .
Wheelchair Options And Accessories
Aetna considers certain wheelchair accessories medically necessary if the wheelchair is considered medically necessary and the options or accessories are necessary for the member to function in the home and perform the activities of daily living.
The following wheelchair options and accessories may be considered medically necessary when the member meets the medical necessity criteria for a wheelchair.Footnotes*
Not Medically Necessary:
Generally a wheelchair accessory/attachment or wheelchair upgrade is considered a convenience item when used to adapt to the outside environment, for work, or to perform leisure or recreational activities.
Upgraded and specialty wheels are considered not medically necessary because they are not required for performance of instrumental activities of daily living.
The following features of a power wheelchair are considered not medically necessary: stair climbing, electronic balance, ability to elevate the seat by balancing on two wheels, and remote operation.
The following wheelchair items are not covered as they are considered personal convenience itemsFootnotes*:
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Where Can I Purchase A Scooter
You can purchase a scooter anywhere you wish if youre paying out of pocket. You can find them online or you can visit your local DME supplier in town.
If youre planning on some help from Medicare however, you need to visit an enrolled DME supplier that accepts the assignment cost from the federal government. Heres more:
Medicare will only cover your DME if your doctors and DME suppliers are enrolled in Medicare. Doctors and suppliers have to meet strict standards to enroll and stay enrolled in Medicare. If your doctors or suppliers arent enrolled, Medicare wont pay the claims submitted by them.
Its also important to ask your suppliers if they participate in Medicare before you get DME. If suppliers are participating suppliers, they must accept assignment. If suppliers are enrolled in Medicare but arent participating, they may choose not to accept assignment. If suppliers dont accept assignment, theres no limit on the amount they can charge you. Medicare.gov
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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What Scooters Does Medicare Cover
It is important to know what mobility scooters are covered by Medicare before you make a purchase. If you purchase a scooter in advance and Medicare does not cover that particular scooter, you will not receive reimbursement for it.
Medicare will cover an electric scooter, referred to as a power-operated scooter. Medicare will not cover a knee scooter.
Will Medicare Pay For Scooter Lifts
In short, no, Medicare will not pay for a scooter lift for your car or van. While Medicare covers a wide range of equipment to use within your home, they do not cover scooter lifts for your car. Medicare Part B specifically covers a portion of the purchase or lease of certain approved types of durable medical equipment . Unfortunately, Part B does not cover things like wheelchair ramps, walk-in tubs or scooter lifts for your car.
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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.
What Are The Medicare Scooter Requirements How To Get A Scooter From Medicare
Your doctor must indicate that you need a mobility scooter for in-home use. Medicare Part B does not cover any costs related to mobility scooters for use strictly outside the home.
Medicare considers covering a mobility scooter only if the beneficiary meets several additional conditions, which include:
- Your doctor and the supplier of the mobility scooter must both be enrolled in Medicare
- You must be unable to perform activities of daily living such as bathing, dressing yourself, moving in or out of a chair or bed or using the bathroom, even with the use of a cane, a crutch, or walker
- You are able to use the scooter within your home, which means that it is not too large to fit between doorways or anything in its path
- You are able to safely operate and get on and off the scooter or have someone who will always be available to help you safely use it
- You must also be able to sit up on the scooter, and to operate the steering system.
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