You might think that the question of whether Medicare covers the expense of acquiring a scooter (also known as a powered mobility device) or manually operated wheelchair would be a straightforward one.
Either Medicare covers the cost or it doesn’t, right? But unfortunately, as with many things associated with Medicare, the answer is less than clear.
So what is the cause of the confusion? And how can you do everything possible to defer the costs if you happen to need mobility assistance? Let’s dig into the details.
If you are enrolled in Medicare, then you’re automatically enrolled in Medicare Part A. Part A is structured to cover hospital expenses.
In general, it pays for inpatient care, nursing home stays, and hospice or in-home health care. Unfortunately, Part A doesn’t cover the costs of a mobility device. As such, we need to look to Medicare Part B for coverage.
Medicare Part B is an optional plan and has a monthly fee associated with enrollment. It differs from Part A in that it covers doctor’s visits, x-rays, lab work, medical equipment, and any tests used to diagnose medical conditions.
And fortunately, Medicare Part B classifies powered operated vehicles and manual wheelchairs as durable medical equipment (DME) that your doctor prescribes for use in your home.
Why The Confusion?
So what’s the source of all of the confusion then? The biggest issue is that eligibility for these mobility devices has come under increased scrutiny over the past several years as a result of doctors over-prescribing these devices to Medicare customers.
As such, the government has cracked down on the eligibility requirements to receive a scooter or wheelchair. So what exactly must you do to have the best odds of approval for your DME request?
The first thing you must do is have a face-to-face appointment with your Medicare approved doctor and receive a written prescription stating that such a device is medically necessary. Next, you need to find, either online or locally, a Medicare approved supplier of these mobility devices. If you choose to purchase a DME out-of-pocket and then submit to Medicare for reimbursement, you will most likely not receive any financial assistance.
Once you find an approved supplier, make contact and explore the options that best fit your needs. Of course, if you have questions or would simply like more information, then don’t hesitate to call our office. We have years of experience navigating the different Medicare plans and we’ll be happy to find the coverage that meets your needs and fits your budget.