Will Medicare Cover Your Wheelchairs?

Will Medicare Cover Your Wheelchairs?

   A wheelchair (manual or electric) can open the door to greater independence

   and a more active lifestyle, especially for individuals who do not have the  

   ability or upper-body strength to move themselves in a manual wheelchair.

   Medicare and private companies offering “Medicare-supplemental-insurance”

   will cover a significant portion of the cost of a power-chair for those who are

   eligible that can represent a meaningful benefit considering power-chairs

   range from $1,500 to $5,000, or more.

     

   Your specific medical need, the type of mobility chair you require, the wheel-

   chair you choose and the state in which you live are factors that contribute to

   eligibility requirements.

   Medicare Eligibility

   Medicare requires the following conditions for a power wheelchair or scooter

   to be covered:

·        You have a medical condition that requires assistance with daily living including getting dressed, taking a bath, getting in or out of the bed or chair, moving around, and using the bathroom.

·        You do not have the upper arm strength or physical ability to operate a manual wheelchair, use a cane, or walker.

·        You have the skills to safely operate the controls of a power wheelchair or scooter in your home, as well as in other environments.

It is important to note that Medicare will not cover the purchase of an electric-

    wheelchair if it will be used primarily for leisure or recreational activities, or

    if it is only needed to move around outside your home. For more information

    on Medicare qualifications, visit www.medicare.gov.

    Steps for Medicare Qualification

1.    Make an appointment with your doctor for a mobility evaluation. Medicare

            requires a face-to-face examination with your treating physician before

            accepting a prescription for a power chair or scooter.

            During your appointment, your doctor will determine if your needs can be

            met by a manual wheelchair, cane or walker before writing an eligible

            prescription for an electric wheelchair.

2.     Have your doctor fax or mail the written prescription and your medical  

            information to your requested wheelchair supplier within 45 days of your   

            face-to-face examination.

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3.    Your wheelchair supplier will work with you and your physician to deter-

           mine the best wheelchair model for your needs. You should "test-drive" a

           number of models to determine which chair is the most comfortable and

           offers the best handling.

      4.  The next step is to complete and submit the Medicare's forms and paper-

           work for processing.

5.    The last step is delivery of your new wheelchair, adjusting the fit to your

           body for complete comfort and learning to operate the controls so you

           can begin to regain your mobility, immediately.

Medicare and most private insurers will cover between 50% and 80% of the allowable price for power chairs. The amount that your insurance company pays will depend, in part, on the type of mobility-chair you require and state in which you live.

Most secondary insurance companies will cover what your primary insurance does not pay. If you do not have secondary insurance or the remaining expense would create a financial hardship, ask for special consideration to help you get the wheelchair you need and want.

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