Your Wheelchair and Mobility Scooter Resource
Friday, May 29th, 2009
Medicare is a federally funded insurance program available to most seniors over the age of 65. In addition to covering the types of things you would expect a private insurance plan to cover, Medicare also covers the cost of many types of home medical equipment. Medicare refers to this equipment as Durable Medical Equipment. Mobility Scooters are covered by Medicare and fall into the category of durable medical equipment.
While Medicare does cover Mobility Scooters, there are a few requirements the insured must meet before ordering a mobility scooter. The main requirement is that the scooter is needed for use both in the home and away. If the insured can get around their home without the scooter and only need it when away from home, it would not be covered.
The other main requirement to receive Medicare coverage of a mobility scooter is that a doctor prescribes the scooter as part of a treatment plan. It is important to speak with your doctor prior to ordering the scooter, to ensure that you are eligible to receive a prescription for the device.
If the insured meets these requirements, then Medicare will typically cover 80% of the cost of the mobility scooter. Most mobility scooter dealers will bill Medicare, so once the insured has a prescription, the process typically goes very smoothly. It is also possible to purchase the mobility scooter first and receive reimbursement later, but always make sure you meet the requirements for Medicare reimbursement before doing this.
While almost all of those who use traditional Medicare will be eligible to receive durable medical equipment, such as mobility scooters, those who use a Medicare Advantage Plan, the process might be a little different. Medicare Advantage Plans are optional plans that are still funded by the federal government, but private insurance companies administer the programs. As a result, while a Medicare Advantage Plan will still cover the same things as Medicare, they often go about it in a different manner.
For those who use a Medicare Advantage Plan, it will be necessary to consult the documentation provided by the private insurance company to see how mobility scooters are covered and what the process is to receive reimbursement.
Wednesday, May 27th, 2009
Medicare is a federally funded insurance program available to most Americans over the age of sixty-five. It is designed to provide affordable health care and covers the cost of doctors visits and prescriptions. In addition to providing coverage similar to that of private insurance, Medicare also covers the cost of Durable Medical Equipment, which is a broad category consisting of many types of home medical equipment.
Wheelchairs, both manual and electric, fall into the category of Durable Medical Equipment and are typically covered by Medicare.
While electric wheelchairs are covered by Medicare, the insured must meet several requirements in order for the device to be covered. One of the main requirements is that the individual is unable to use a manual wheelchair. They must also be able to transfer into and out of the wheelchair and able to operate the electric wheelchair in a safe manner.
In addition to the above physical requirements, the electric wheelchair must also be prescribed by a doctor as part of a treatment plan. In most cases, Medicare will only cover one electric wheelchair every five years, so if they have previously provided reimbursement for a wheelchair, it might not be available.
With a doctors prescription and assuming the insured meets the other physical requirements, Medicare will typically provide reimbursement for up to 80% of the cost of an electric wheelchair. Some companies will directly bill Medicare, although it is usually also possible to buy the electric wheelchair first and apply for reimbursement later. However, if you go this route ensure that you meet Medicare’s requirements first and will be eligible to receive reimbursement.
For those who use a Medicare Advantage Plan (MMA) the rules for reimbursement may vary, so it will be necessary to check with the company that runs this plan. A Medicare Advantage Plan is available to those eligible for Medicare and covers the same things as traditional Medicare, but is run by a private insurance company. As a result, the way some things are covered and reimbursement received can be a little bit different, but Medicare Advantage Plans are required to cover the same things as traditional Medicare.