Here is a list of steps to help you get your scooter covered and in your home:
- Apply for and enroll in original Medicare (parts A and B).
- Make an appointment with a Medicare-approved doctor for a face-to-face visit to confirm your eligibility for a scooter.
- Have your doctor send a written order to Medicare indicating your eligibility and need for a scooter.
- Decide which type of scooter you need and if you’d rather rent or buy.
- Look for a Medicare-approved DME supplier who accepts assignment here.
- If you cannot afford the cost of the scooter, call your local Medicare or Medicaid office to determine your eligibility for Medicare savings programs which may help.
How to get an electric scooter through Medicare?
The specific amount you’ll owe may depend on several things, like:
- Other insurance you may have
- How much your doctor charges
- Whether your doctor accepts assignment
- The type of facility
- Where you get your test, item, or service
Are scooters covered by Medicare?
Yes, Medicare Part B covers scooters that will be used in the home. Medicare must receive a prior authorization request from your supplier to ensure coverage. How do I get Medicare to pay for a scooter?
Will Medicare pay for a scooter?
Your wheelchair or scooter will be covered only if your doctor and your equipment supplier are enrolled in Medicare. Medicare will pay most of the cost of your wheelchair or scooter if all of these conditions are met: Your doctor submits an order stating your medical need for a wheelchair or scooter.
Is a mobility scooter covered by Medicare?
Mobility scooters are quite expensive to purchase hence the common interest for them to be covered by Medicare. Medicare provides coverage for DME (Durable Medical Equipment) that meet specific requirements. The coverage of mobility scooters fall under the category of Medicare Part B. It also includes outpatient expenses.
Does Medicare provide scooters?
Medicare Part B (Medical Insurance) covers power-operated vehicles (scooters), walkers, and wheelchairs as durable medical equipment (DME). Medicare helps cover DME if: The doctor treating your condition submits a written order stating that you have a medical need for a wheelchair or scooter for use in your home.
What mobility scooters are approved by Medicare?
Available Power Scooters Covered by MedicareGo-Go Elite Traveller® Power Scooter. The Go-Go Elite Traveller® is a power scooter Medicare covers. ... Maxima Power Scooter Medicare Covered. The Maxima 4-Wheel Scooter is one of the other optional power scooters covered by Medicare. ... Victory® 9.2. Power Scooter.
How Much Does Medicare pay on mobility scooters?
How Much Does Medicare Pay for Mobility Scooters? Medicare Part B has a deductible and a 20% coinsurance. If you've already met your deductible, Medicare Part B will pay 80% of the cost of an approved mobility scooter. You will be responsible for the remaining amount.
What qualifies for a wheelchair diagnosis?
Which Diagnoses Qualify for Wheelchairs?Multiple Sclerosis (MS)ALS (AKA Lou Gehrig's Disease)Parkinson's Disease.Spinal Cord Injuries.Cerebral Palsy.Muscular Dystrophy.CVA (AKA stroke-related paralysis)Post-Polio Syndrome.More items...
What is the best mobility scooter to buy?
Best Mobility Scooters Of 2022Pride Mobility Raptor.Ewheels M39 Mobility Scooter.Drive Medical Cobra GT4.Go-Go Elite Traveller 4-Wheel.Drive Medical Scout 4.Pride Mobility Go-Go Sport 4.Pride Mobility Zero Turn 10.Ewheels EW72 Mobility Scooter.More items...•
Will Medicare pay for a walker and a wheelchair at the same time?
Q: Will Medicare cover the cost of wheelchairs and walkers? A: Yes. Medicare Part B covers a portion of the cost for medically-necessary wheelchairs, walkers and other in-home medical equipment.
Can I get help to buy a mobility scooter?
You might be able to get a grant or help from a charity. The Motability Scheme can help if you want to hire or buy a mobility scooter. It allows some people to use their benefits to pay for one.
Do you have to be disabled to use a mobility scooter?
Who Can Drive a Mobility Scooter? Not just anyone can drive a mobility scooter! You can drive a mobility scooter only if you have a physical disability, or limited mobility because of an injury or medical condition.
What is a Class 3 mobility scooter?
A class 3 mobility scooter is a type of scooter that can be used on the road. Class 3 mobility scooters have top speeds of up to 8 MPH on the road, and a top speed of 4 MPH off the road.
How do I ask my doctor for a wheelchair?
To get a power wheelchair, your doctor will need to examine you in person. After your exam, your doctor will need to write an order saying that you're capable of using a power wheelchair safely and explaining why you need one. Certain types of power wheelchairs need a “prior authorization” before you can get one.
What kind of wheelchair Will Medicare pay for?
Medicare benefits cover manual wheelchairs, power scooters, and power wheelchairs. It's important to verify that your doctor and your medical equipment supplier are both enrolled in Medicare before you get a wheelchair.
What is the difference between a scooter and a power wheelchair?
One of the biggest differences between a scooter and a power chair is how they are operated. Mobility scooters are equipped with a tiller and handle bars, as opposed to a power wheelchair, which is operated using a joystick.
What happens if you don't enroll in Medicare?
If your doctors or suppliers aren’t enrolled, Medicare won’t pay the claims submitted by them. Make sure your doctors and DME suppliers are enrolled in Medicare. It’s important to ask your suppliers if they participate in Medicare before you get DME.
What percentage of Medicare payment does a supplier pay for assignment?
If your supplier accepts Assignment you pay 20% of the Medicare-approved amount, and the Part B Deductible applies. Medicare pays for different kinds of DME in different ways. Depending on the type of equipment:
Does Medicare cover DME equipment?
You may be able to choose whether to rent or buy the equipment. Medicare will only cover your DME if your doctors and DME suppliers are enrolled in Medicare. Doctors and suppliers have to meet strict standards to enroll and stay enrolled in Medicare.
Does Medicare cover wheelchairs?
Medicare Part B (Medical Insurance) covers power-operated vehicles (scooters) and manual wheelchairs as durable medical equipment (DME) that your doctor prescribes for use in your home. You must have a face-to-face examination and a written prescription from a doctor or other treating provider before Medicare helps pay for a power wheelchair.
Do you have to get prior authorization for a wheelchair?
Starting September 1, 2018, you may have to get prior approval (known as “prior authorization”) for certain types of power wheelchairs. Under this program, 40 types of power wheelchairs require “prior authorization” before Medicare will cover the wheelchair cost.
Does Medicare get all the information needed to make a decision?
Medicare doesn’t get all the information needed to make a decision
Can a DME provider provide a prior authorization for a wheelchair?
If your physician prescribes one of these wheelchairs to you, your DME supplier will, in most cases, submit a prior authorization request and all documentation to Medicare on your behalf . Medicare will review the information to make sure that you’re eligible and meet all requirements for power wheelchair coverage.
What are the requirements for a scooter?
You must meet the following criteria: Your doctor must submit a written order stating that you have a medical need for the scooter for use inside of your home. You have limited mobility. You have a medical condition that limits your mobility around your home.
What are the health benefits of a scooter?
People suffering with respiratory issues, COPD, multiple sclerosis, severe arthritis, obesity, and other serious health conditions often benefit from a scooter’s unique features.
What is the difference between a scooter and a wheelchair?
Physicians will often prescribe a motorized wheelchair for patients who need assistance at most times and will use it mainly inside the home. A scooter, on the other hand, expands the range of travel for someone struggling with mobility.
Can a doctor prescribe a scooter?
Motorized wheelchairs and scooters can be prescribed by your physician as medically necessary durable medical equipment. Depending on your specific needs, a doctor may prescribe a traditional wheelchair, scooter, or motorized wheelchair.
Does Medicare cover scooters?
The scooter fits and can be used within your home. If you have Original Medicare, you will likely pay 20% of the Medicare-approved amount, and the Part B deductible applies. If you are enrolled in a Medicare Advantage plan, you will have at least the same Part A and Part B coverage as Original Medicare, but many MA plans offer additional benefits.
Can you get a scooter if you lost your license?
If a patient has good vision, hearing, and cognitive skills and can get in and out of the scooter without help and operate it safely, a physician may choose to order a scooter.
Can you drive a scooter without a license?
A scooter can help you move around comfortably inside your home, but can be used outdoors as well. If you are unable to drive due to vision problems or other health concerns, a scooter can help you maintain an active lifestyle without a driver’s license.
Medicare Requirements
A personal mobility device (PMD) is covered by Medicare only if three criteria are met: 2
Healthcare Provider Requirements
Healthcare providers bear the burden of prescribing a mobility scooter or powerchair to disabled people who need them in order to perform necessary and daily activities inside their home. These motorized vehicles can make a big difference in their mobility, especially if they have little or no upper body strength.
Assessment of Your Medical Needs
You must address specific questions in your face-to-face interview with a healthcare provider. Specifically, you or your caregiver must answer: 1
Out-of-Pocket Purchase
Some people might benefit from PMDs but do not meet the strict medical necessity guidelines to obtain one through Medicare.
How to report scooter fraud?
If you suspect fraud, call 1-800-MEDICARE (1-800-633-4227) to report the incident.
How many people use scooters in California?
According to the University of California’s Disability Statistics Center, about 6.8 million people rely on mobility scooters to get around their homes. Electric scooters may help give people independence and freedom who might otherwise be left in bed. If you’re looking for a Medicare-approved mobility scooter, first you have to qualify to receive one.
What are some examples of scooter fraud?
Another example of scooter fraud is suppliers actually giving people scooters who don’t need them. According to the Washington Post, Medicare fraud has been a “top concern in Washington for decades.”. Possible signs of scooter fraud are a supplier offering you a “free” scooter, offering to pay you in cash or to waive your copay, ...
What is a Medigap plan?
A Medigap (Medicare Supplement) plan is a type of private insurance policy that can help pay for financial items such as Medicare coinsurance (like the 20 percent you’d pay for a scooter) and copays. In 2019, Medigap plans have 10 different coverage levels and each one is assigned a letter.
What is Medicare Advantage?
Medicare Advantage plans are private insurance policies that can provide coverage for more services than Original Medicare. Even though Medicare Supplement and Medicare Advantage sounds similar, they are actually very different.
How long does it take to receive a mobility device order?
The mobility device supplier must receive the order within 45 days of your in-person evaluation.
Does Medicare cover mobility scooters?
A Medicare Advantage plan may offer reduced fees for mobility scooters, however, your exact cost depends on your plan.
What is an electric scooter?
An electric scooter, otherwise known as a mobility scooter or power-operated vehicle, is a prized aid for anyone who encounters difficulty when walking for a lengthy time period. Similar to a motorized wheelchair, styles can vary. The basic components include a tiller, handlebars and four wheels. Any device that promotes ...
Why do people use electric scooters?
An electric scooter fosters independence, societal participation and social interaction.
What does "enrolled" mean in Medicare?
Enrolled means they have signed up to accept Medicare insurance. Enrollment holds the providers to stringent standards. Assignment means they agree to be paid directly by Medicare, to accept the approved amount, and to bill the Medicare recipient no more than the deductible and coinsurance.
Can Medicare beneficiaries use an electric scooter?
Many Medicare recipients face mobility issues due to illness or injury. An electric scooter can be the right solution for many seniors and Medicare recipients under the age of 65 with certain disabilities.
Does Medicare cover electric scooters?
Medicare insurance can help cover the costs of an electric scooter if you meet specific criteria. Medicare Benefits for Durable Medical Equipment. Medicare benefits for both power-operated scooters and manual wheelchairs fall under the category of durable medical equipment (DME).
How to get a copy of Medicare's wheelchair and scooter benefit?
For more information, call Medicare at 800-633-4227 and request a copy of publication #11046 " Medicare's Wheelchair and Scooter Benefit ."
How to contact Medicare about wheelchair and scooter?
Talk to a supplier about this option. For more information, call Medicare at 800-633-4227 and request a copy of publication #11046 “ Medicare’s Wheelchair and Scooter Benefit .”. Medicare Advantage.
What to do if my mom has a Medicare Advantage plan?
If your mom happens to have a Medicare Advantage plan (like an HMO or PPO), she’ll need to call her plan to find out the specific steps she needs to take to get a wheelchair or scooter. Many Advantage plans may have specific suppliers within the plan’s network they’ll require her to use.
Is Medicare dependent on my mom?
It’s also important to know that Medicare coverage is dependent on your mom needing a scooter or wheelchair in her home. If her claim is based on needing it outside her home, it will be denied as not medically necessary, because the wheelchair or scooter will be considered as a leisure item. Where to Shop.
What scooter does Medicare cover?
This includes mobilized scooters and manual wheelchairs. Will medicare pay for a knee scooter as well? Knee scooters do not meet the program’s requirements, so they are not covered.
How much does a mobility scooter cost?
How much does a mobility scooter cost? Prices for mobility scooters vary according to their features such as maximum speed and other options. Three-wheel travel scooters start around $600, and four-wheel travel scooters around $650. Full-sized scooters are significantly more expensive.
How do I get durable medical equipment through Medicare?
To find out if Medicare covers the equipment or supplies you need, or to find a DME supplier in your area, call 1-800- MEDICARE or visit www. medicare.gov. You can also learn about Medicare coverage of DME by contacting your State Health Insurance Assistance Program (SHIP).
How do I get Medicare to pay for wheelchair ramp?
Medicare never covers home modifications, such as ramps or widened doors for improving wheelchair access. Though your doctor may suggest that home modifications may help due to your medical condition, Medicare does not include coverage for them under its durable medical equipment (DME) benefit.
Can I get help to buy a mobility scooter?
The Motability Scheme can help if you want to hire or buy a mobility scooter. It allows some people to use their benefits to pay for one.
What is not covered by Medicare?
Some of the items and services Medicare doesn’t cover include: Long-term care (also called Custodial care ) Most dental care. Eye exams related to prescribing glasses.
How Much Does Medicare pay for durable equipment?
Medicare will pay 80% of the Medicare -approved amount (up to the cost of replacing the item) for repairs. You pay the other 20%. Your costs may be higher if the supplier doesn’t accept assignment.
How to find out if you have insurance for a mobility scooter?
In order to figure out if you can receive an insurance-covered mobility scooter, your first step should be to meet with your physician. Ask him or her about mobility scooters in relation to your specific condition. If lacking a mobility scooter causes you enough pain and stress when moving around then your doctor will write you a prescription ...
How much does a mobility scooter cost?
First of all, mobility scooters not only range in terms of different types but they also range in different prices. Some mobility scooters cost around $2000 but others cost less than half this much. If you end up getting a mobility scooter that costs $800 then you’ll only have to pay $160 out of pocket.
What are the requirements for a scooter?
By Medicare standards, the written order by your doctor that states you have a medical need for a scooter needs to meet all of the following conditions: 1 You have a health problem or condition that drastically affects your movement throughout your home and elsewhere 2 You have major problems performing basic tasks even if you have a cane, crutch or a walker 3 Your condition is not so debilitating that you are still capable of driving, mounting and removing yourself from the mobility scooter without the help of others, or you always have someone with you to help you with this 4 Both your physician and your supplier are enrolled with Medicare. 5 The mobility scooter is not too large for your home
What are the medical conditions for a scooter?
By Medicare standards, the written order by your doctor that states you have a medical need for a scooter needs to meet all of the following conditions: You have a health problem or condition that drastically affects your movement throughout your home and elsewhere.
Is a Medicare scooter worth it?
It may seem like you have to jump through some hoops but we assure you that acquiring the medical prescription for a Medicare-covered mobility scooter is absolutely worth it. Only having to pay one-fifth of the price is certainly nothing to scoff at and will undoubtedly be a huge help to you, as we’re sure you’ll agree.
Do you need a prescription for a mobility scooter?
If lacking a mobility scooter causes you enough pain and stress when moving around then your doctor will write you a prescription for one. This prescription is proof that you need in order to receive a mobility scooter. This is what will tell insurance and/or medicare providers that a mobility scooter is a medical necessity for you.
Does Medicare cover mobility scooters?
Medicare and insurance companies can and will help cover your expenses for acquiring a mobility scooter. As long as you can prove that it is a medical necessity rather than a convenience, then you will receive your mobility scooter with most of the cost covered. Check out our top picks for the best medical scooters!
Medicare Requirements
Healthcare Provider Requirements
- Healthcare providers bear the burden of prescribing a mobility scooteror powerchair to disabled people who need them in order to perform necessary and daily activities inside their home. These motorized vehicles can make a big difference in their mobility, especially if they have little or no upper body strength. The PMDs primarily must be used within the home, so they must fit throug…
Assessment of Your Medical Needs
- You must address specific questions in your face-to-face interview with a healthcare provider. Specifically, you or your caregiver must answer:1 1. What is your mobility challenge and how does it interfere with your daily activities? 2. Why can’t a cane or walkerhandle your mobility needs? 3. Why can’t a manual wheelchair be used to meet your mobility needs? 4. Are you capable of trans…
Out-Of-Pocket Purchase
- Some people might benefit from PMDs but do not meet the strict medical necessity guidelines to obtain one through Medicare. There is no restriction on buying a mobility scooter or power chair from a supplier if you want to purchase it out-of-pocket with no insurance support. Several suppliers both nationally and locally (usually nearby to hospitals...