Inevitably, age and illness will affect us all. When they do, a powered wheelchair or mobility scooter can return precious mobility to those who have lost the power of ambulation. Whether you’re looking to obtain a power wheelchair for yourself or a loved one, here is the process you’ll have to go through.
Medicare is designed to provide health insurance to persons aged 65 and over and those with disabilities. The program has several parts. Part B pays for “Durable Medical Equipment” (DME), such as a power wheelchair or mobility scooter.
The first step to obtaining a power wheelchair covered by Medicare is to have an in-person assessment of the recipient’s health by a qualified medical provider. If the recipient is considered eligible for coverage, Medicare will cover 80% of the cost of the chair. The price and type of chair will depend on the needs of the patient.
Mobility scooters usually cost between $800 and $1,000, and an electric folding wheelchair, powered wheelchair, or motorized wheelchair can cost between $2,000 and $15,000. The recipient will be required to pay a Part B deductible that should run between $150 and $200. He or she will also need to pay the remaining 20% of the cost of the chair.
Steps to Getting an Electric Wheelchair Funded by Medicare
Step 1: Make an Appointment
In the face to face medical checkup, the recipient will have her or his needs assessed. The doctor will determine eligibility by looking at the following factors;
- The ability of the recipient to move around independently, and whether any mobility limitations make necessary daily life activities impossible or unsafe.
- Whether or not the recipient has significant trouble performing self-care tasks such as bathing, dressing, and toileting.
- The ability of the recipient to safely use a power wheelchair as a mobility aid, or if he or she needs the aid of another person.
- The recipient’s ability to safely and effectively operate a chair of a given type.
Step 2: Choosing Your Chair
Once a physician has determined that the recipient does need a powered wheelchair, he will give a certificate of medical necessity (CMN). With this, the recipient will go to a Medicare-approved wheelchair supplier. Keep in mind that the CMN will expire in 45 days. Approved suppliers can be reached via medicare.gov/supplier or by calling 800-633-4227.
Your local approved Medicare supplier will send a representative to the home of the recipient to assess the home and the needs of the patient.
Step 3: Financial Assistance
If the recipient has a Medicare supplemental policy, it might help with the remaining 20% of the cost not ordinarily covered. If not, and if he or she cannot afford the 20%, your local Medicaid office might be able to help through their Medicare Savings program. Call the number above and ask for publication #11046 “Medicare’s Wheelchair and Scooter Benefit.”
Step 4: Assessing Medicare Advantage
If the recipient of the chair has a Medicare Advantage plan (like an HMO or PPO), he or she will need to call the coverage providers to find out what steps need to be taken to obtain a power wheelchair or mobility scooter. Most Medicare Advantage plans use their own suppliers that are tied into their plan’s networks, which they will need to use.