Medicare Blog

how to get medicare to cover a scooter

by Mia Toy Published 1 year ago Updated 1 year ago
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In order for Medicare to help pay for a power scooter, you must have limited mobility and meet all of the following conditions:

  • Your doctor must submit a written order stating that you have a medical need for a scooter to use at home.
  • You have a health condition that causes extreme difficulty moving around your house.
  • You can’t engage in daily living activities such as bathing, dressing, getting in or out of bed or a chair, or using the bathroom, even with an assistive device.
  • You’re able to safely operate the scooter including getting on and off the device, or you have a caregiver with you at all times to help you use the device ...
  • You can use the equipment in your home (for example, it’s small enough to fit through your doors).
  • Both your doctor and the equipment supplier are Medicare-approved.

Does Medicare cover power scooter?

Power scooters increase mobility to make everyday tasks possible again for many individuals. They are a great choice for this, but they are quite expensive. Medicare will provide coverage for mobility scooters if you are able to meet certain requirements.

Does Medicare cover electric scooters?

The short answer is yes; Medicare will cover the cost of electric scooters. But not 100% of the time. As is often the case with Medicare, certain conditions have to be met for Medicare to pay for your electric scooter. Below we look at what these are so you know what to expect.

Does Medicare cover wheelchairs and walkers?

Original Medicare (Part A and Part B) does cover wheelchairs and walkers, though there are certain restrictions and guidelines you should know about. These items are categorized as “ durable medical equipment ” ( DME) and are covered by Medicare Part B.

Does Medicare cover Hoveround?

Is hoveround covered by Medicare? December 7, 2021 Answerthirst Editor. The cost of your power chair may vary based on your insurance coverage. However, 9 out of 10 customers received their Hoveround for little or no cost.1 If you meet the criteria, Medicare will pay 80% of the cost of your Hoveround and if you have met.

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Will Medicare reimburse me for a scooter?

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 can I get a free scooter?

Thankfully, regardless of your financial status, there several ways to get a free mobility scooter without paying a penny.Medicare.Your Insurance Company.Grants and Charities.The American Outreach Foundation.Latter-day Saint Charities.Social Security and State Disability Assistance.

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...

Does Medicare pay for hoveround?

If you meet their criteria, Medicare will pay 80% of the cost of your Hoveround, and if you have met your deductibles, your supplemental insurance may cover the remaining 20% of the cost.

Will Medicare pay for a walker?

Medicare generally covers walkers as part of “durable medical equipment.” To get full coverage, you may need a Medicare Supplement plan. A walker may be essential for you if you struggle to walk without support.

Can you get a grant towards a mobility scooter?

If you need you need financial help for a mobility scooter. It is possible to apply to a number of charitable organisations for financial assistance with mobility products funding, whatever your age. Each charity has its own criteria both regionally and nationally, to make the process as easy as possible.

Can I pay monthly for a mobility scooter?

You can make use of pay monthly options to spread the cost over 12, 24, 36 or 48 months. It is also possible to arrange finance options for your mobility scooter with a deposit that is as little as 10% of your scooter's value.

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.

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 is the difference between a scooter and a power wheelchair?

Power chairs allow steering with just a person's fingertips. Hands and arms are also supported at all times on a power chair. Electric scooters are controlled with handlebars, or “tillers,” which require more upper body strength. This is because the tiller/handlebars must be able to be held for extended time periods.

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 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 scooter be used for assisted living?

Independence can become a challenge as we age, but a scooter can help prevent or postpone the need for assisted living. Maintaining a safe environment is essential inside and outside your home. A scooter can help you move around comfortably ...

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.

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.

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.

Will Medicare help pay for a mobility scooter?

Medicare Part B coverage includes durable medical equipment. Medicare will only cover DME that you have a medical need for, so there are some restrictions.

Are mobility aids covered during inpatient hospitalization?

If you are hospitalized and require some type of mobility aid, the hospital will provide it for you. This coverage comes from Part A, which covers inpatient care, rather than Part B.

How to get a mobility scooter approved by Medicare

To get a mobility scooter approved by Medicare, you must be evaluated by a doctor to confirm medical necessity. This evaluation can be conducted by an occupational therapist. To go this route, your doctor will have to certify that you need to consult with an occupational therapist and then write a prescription for the scooter.

What you'll pay for a mobility scooter with Medicare

If you qualify, Medicare will cover your mobility scooter in the same way that it covers most other services. You will have a coinsurance of 20% if your DME provider accepts Medicare assignment, while Medicare pays the remaining 80%. You will also have to meet your Part B deductible before Medicare coverage starts. This comes to $233 in 2022.

Make sure your DME supplier is enrolled in Medicare

Not every DME supplier is enrolled in Medicare. If you choose a DME supplier that isn’t enrolled in Medicare, then Medicare will not pay any claims that the supplier sends them, meaning you will be responsible for 100% of the cost.

Medicare Advantage coverage for mobility scooters

Medicare Advantage, or Part C, is a way for you to get Medicare coverage through private health insurance companies. Although it involves some qualities that are not part of Original Medicare such as provider networks, Part C plans are required to cover the same things that Original Medicare covers.

What is durable medical equipment?

Durable medical equipment refers to equipment that you use for medical reasons. This can vary widely, and includes things like canes, blood sugar monitors, oxygen equipment, and hospital beds.

Requirements for Medicare to Cover a Mobility Scooter

To qualify for a power mobility scooter, the beneficiary must be unable to perform basic activities like getting out of bed or going to the restroom.

How Much Will Medicare Pay for a Mobility Scooter?

Part B will pay 80 % of the Medicare-approved amount after the Part B deductible has been met. The Part B deductible is $233.

Will a Medicare Supplement Plan Pay for a Mobility Scooter?

Yes, a Medicare Supplement plan will always cover the 20% coinsurance that Original Medicare doesn’t cover. Depending on the letter plan you enroll in, you may have zero out-of-pocket costs for a mobility scooter.

Will a Medicare Advantage Plan Pay for a Mobility Scooter?

Yes, but your cost-sharing is a little more complicated. Since Medicare Advantage plans are not standardized by the federal government, the carrier can choose how much they will cover.

How Do I Find a Medicare-Approved Mobility Scooter Supplier Near Me?

To find a durable medical equipment supplier that’s approved by Medicare, you can use the DME search tool on the Medicare website.

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.

Is a cane covered by Medicare?

The patient is unable to participate in Mobility-Related Activities of Daily Living (MRADLs) like going to the bathroom, feeding, or dressing. A cane or walker is not enough to safely and sufficiently help.

Do doctors prescribe powerchairs?

Physicians 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.

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 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.

Does Medigap pay for Medicare?

Medigap plans help pay for Original Medicare-related fees. Medicare Advantage plans offer coverage for the same services as Original Medicare, but they can also offer additional benefits such as hearing, dental, vision, and fitness classes.

Can Medicare pay for a power scooter?

In order for Medicare to help pay for a power scooter, you must have limited mobility and meet all of the following conditions: Your doctor must submit a written order stating that you have a medical need for a scooter to use at home. You have a health condition that causes extreme difficulty moving around your house.

Can you get a manual wheelchair instead of a mobility scooter?

The Centers for Medicare and Medicaid (CMS) categorizes some other mobility aids as Durable Medical Equipment. You may qualify for a manual or power wheelchair instead of a mobility scooter.

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