Will Medicare Pay For An Electric Wheelchair?

An excellent electric wheelchair assists anyone who cannot walk or has mobility issues and are unable to operate a wheelchair manually. With various powered wheelchairs in the market, you can come across a wide range of pricing as well, which can make you wonder if your Medicare can pay for it. 

Hence, today we will try to answer all your medicare questions regarding the purchase of wheelchairs so that you are not left with any doubts.

Medicare Requirements for Paying for an Electric Wheelchair: 

1. Your condition makes it difficult to carry out daily activities:

In order to acquire the Medicare benefits, you must have a health condition that impacts your mobility. The symptoms and conditions should be terrible enough for you to carry out your daily chores and explain your requirement for an electric wheelchair. These conditions may describe your difficulty in moving from one room to another or getting up from bed, which cannot be solved from a cane or walker.

2. You have a Medicare-enrolled doctor and a Medicare-approved supplier.

Since different states have distinct rules and regulations when it comes to Medicare, you must be assured that both your physician and the DME supplier are enrolled in Medicare. The rule implies that you have to use a specific supplier who is on Medicare’s list of approved suppliers.

3. You have a doctor’s written order:

Medicare will only cover the cost of the electric wheelchair when it is prescribed by your doctor. Your doctor must render you a written order prescribing an power wheelchair for your mobility issues, proving that it is medically necessary. 

4. You can operate an electric wheelchair safely.

An electric wheelchair is approved by Medicare only if you are able to use it efficiently and safely. If you are showing inconvenience in using the device, then you must appoint someone who will be helping you out with it. However, suppose it is found that it is unsafe to use an electric wheelchair privately or publicly for you and your surroundings due to blindness or deteriorating mental capacity or anything else. In that case, Medicare will not be approving it. 

Are power wheelchairs covered by Medicare?

Yes, power wheelchairs are covered by Medicare. Since electric wheelchairs and other durable medical equipment (DME) are considered as prescriptions and medically necessary, that is why electric wheelchairs are covered under Medicare Part B.

However, Part A of Medicare also covers wheelchairs, but they are covered only if the patient is hospitalized. 

So, some Medigap plans and Medicare Part B will pay the major (80%) portion of the cost for your power wheelchair as long as you meet the above-mentioned conditions or criteria. 

Steps for Medicare Power Wheelchair Coverage

Medicare Part B covers your medical insurance that can be implemented for outpatient care, medical supplies, and preventive services. To start with the process of getting Medicare to pay for your electric wheelchair, you must abide by the ideal conditions: 

Step 1

You must get a supplier who is enrolled in Medicare. Some of the questions that you must ask when you look for a supplier are:

    1. Do you consider Medicare assignment?

    2. Would you consider an assignment in my case, even if you don’t consider Medicare assignments generally?

    3. Will you bill Medicare for me?

    4. Are you a Medicare-enrolled supplier?

A supplier who is enrolled in Medicare must meet the strict standards to acquire the Medicare supplier number. Without this number, Medicare can deny the claim and won’t be paying for it even if your supplier sells more than just DME. 

Step 2

After setting up all the conditions and criteria required, your supplier will request “prior authorization” for certain types of power wheelchairs. Then the required documents will be then sent to Medicare along with the request. 

Step 3

According to the regulations and general standards, you will be required to pay 20% of the Medicare-approved amount after paying your Part B deductible for the year. The other 80% is paid by Medicare. You may also choose to rent or buy the equipment, given your present needs and the amount Medicare is willing to pay, since the amount payable by you may vary due to the DME. 

Step 4

Your supplier will receive a decision letter from Medicare regarding your electric wheelchair, which will contain the conclusion of the process. Either your request will be accepted or denied on the grounds of fraud or inadequate information.

 

Conclusion: 

Medicare pays for different kinds of DME in different ways, which makes it crucial for you to understand the kind of equipment you want to purchase or rent and the process required to claim the amount to be paid by Medicare. 

PensionsWeek is dedicated to providing all the relevant information related to retirement plans and gear. We aim at our sole purpose of rendering an effortless and efficient retirement life with ease in mobility. Whether you decide to get a recliner chair or think about plans that can assist you during your retirement, we are here for you. 

If we were able to help you in understanding the Medicare plans and how they can pay for your electric wheelchair, you might like to visit our website and enlighten yourself with much more knowledge, products, and guidance.

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