New Wheelchairs Though Medicare
Qualifying for a New Scooter or Power Wheelchair Through Medicare
Medicare offers coverage for mobility equipment for patients who meet their guidelines. If you have Medicare and you have difficulty performing daily tasks in the home, you might qualify for a mobility solution at low or no cost. If you qualify, Medicare may cover up to 80% of the cost.
A Mobility Alliance Group member will help you through the process of qualifying.
Our members will:
- Explain the entire process to you
- Handle all of the paperwork
- Handle Medicare Billing for mobility equipment
For reference, below are the specifics for qualifying for mobility equipment through Medicare. Please fill out the form above to contact us for a free, no obligation consultation and receive more information.
Qualifying for a Power Wheelchair
- The user must be eligible for a defined Medicare benefit category.
- The product must be reasonable and necessary for the diagnosis or treatment of an illness or injury or to improve the functioning of a malformed body member.
- The user must meet all other applicable Medicare statutory and regulatory requirements.
A power wheelchair is covered when all of the following criteria are met:
- The patient's condition is such that without the use of a wheelchair the patient would be unable to perform daily activities in their home, and
- The patient's condition is such that a wheelchair is medically necessary and the patient is unable to operate a wheelchair manually, and
- The patient is capable of safely operating the controls for the power wheelchair
Qualifying for a Scooter
The basic coverage criteria for a mobility scooter is the same as it is for a power wheelchair. The specific requirements do vary, however, and are as follows:
- The patient's condition is such that without the use of a wheelchair the patient would not be able to move around in their residence; and
- The patient is unable to operate a manual wheelchair; and
- The patient is capable of safely operating the controls of the scooter or power wheelchair; and
- The patient can transfer safely in and out of the scooter or power wheelchair and has adequate trunk stability to be able to safely ride in the scooter or power wheelchair; and
- It is ordered by a physician who is one of the following specialties: Physical Medicine, Orthopedic Surgery, Neurology, or Rheumatology
- When such a specialist is not reasonably accessible (e.g., more than one day's round trip from the beneficiary's home or the patient's condition precludes such travel), an order from the beneficiary's physician may be acceptable.
- A new scooter or power wheelchair will be denied as not medically necessary when it is needed only for use outside of the home. A scooter or power wheelchair primarily allowing the user to participate in leisure or recreational activities will be denied as not medically necessary.
- A scooter or power wheelchair that because of its size or features is primarily intended for outdoor use will be denied as not medically necessary. Medicare will not provide a new wheelchair in these case.