Medicare Blog

how to get mobility scooter approved by medicare

by Leatha Erdman Published 2 years ago Updated 1 year ago
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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. The beneficiary must obtain a written doctor’s order stating the mobility scooter is medically necessary. The doctor will need to specify that the patient has limited or no mobility as well as a serious health condition that limits movement about the home.

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.

Full Answer

How much do you want a Medicare covered mobility scooter?

You typically pay 20% of the Medicare-approved amount for your scooter (if Medicare approves your scooter for coverage under Part B). Before Medicare will pay the remaining 80 percent, however, you must meet your Part B deductible, which is $185 per year in 2019. Nov 6 2019 Are electric wheelchairs and scooters covered by Medicare?

Does health insurance fully cover mobility scooters?

Your health insurance plan might pay for a scooter under certain circumstances. Health insurance companies will not automatically approve the purchase of a mobility scooter. They will require that your physician submit medical justification to them and even then sometimes a health insurance claim for a mobility scooter can be denied.

Are mobility scooters sometimes covered by Medicare?

Power-operated scooters, walkers and wheelchairs are all considered durable medical equipment (DME), which is typically covered by Medicare Part B. A Medicare Supplement Insurance (Medigap) plan can help cover mobility scooters by paying for costs such as Medicare deductibles, coinsurance and more.

What is the best rated mobility scooter?

  • Plenty of storage
  • 35bhp is great
  • 400cc single-cylinder
  • Bargain value
  • Lightweight and small
  • Rated for kid-use
  • Excellent extra features
  • 2019 uprated

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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.

Does Social Security pay for mobility scooters?

Social Security and State Disability Assistance State issued disability benefits can cover the full, or part, of the cost of a much-needed mobility scooter. Social Security and disability assistance should be able to help you.

Can you use a mobility scooter if you are not disabled?

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 Category 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 Much Does Medicare pay on mobility scooters?

Medicare's Wheelchair & Scooter Benefit 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. You pay 20% of the Medicare-approved amount, after you pay your Part B deductible for the year. Medicare pays the other 80%.

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...

Can I claim for a mobility scooter?

A mobility scooter crash injury could cause financial costs and losses too. These could include loss of income, care costs, travel expenses and medical expenses too. If you have suffered financial loss due to your injuries sustained in a mobility scooter accident, you could claim them back under special damages.

Do I have to register a mobility scooter?

If your mobility scooter or powered wheelchair is not a registered vehicle. Most scooters and wheelchairs will already be registered by the dealer or manufacturer before you buy them. If your vehicle is not registered, register it by filling in: form V55/4 for new vehicles.

What is a class B mobility scooter?

Class 2 mobility scooters can only be used on footpaths, pavements, and when crossing roads. They have a maximum speed of 4mph (6.4kph). Key features of class 2 scooters: can be used indoors. small, lightweight and compact.

What's the difference between a Class 2 and Class 3 mobility scooter?

Class 3 mobility scooters are larger and bulkier than Class 2 models and are designed more along the lines of a small car. You'll often find Class 3 mobility scooters referred to as Road Class Scooters since, with a top speed of 8mph, they're designed to be used primarily on roads as well as on pavements.

What is a class two mobility scooter?

Class 2 mobility scooters/powerchairs are defined as mechanically propelled mobility vehicles with a maximum speed of 4mph. Class 2 scooters/powerchairs tend to be more lightweight and compact, being they are easier to transport in a vehicle and can be driven indoors with ease.

Are mobility scooters allowed on the pavement?

Can I go on the pavement with a mobility scooter? Yes – in fact, it is preferred that mobility scooters are driven on pavements where they are available, as pavements are safer than roads. This means that mobility scooters should only be driven on roads when there is no suitable pavement to drive on.

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.

Does Medicare Cover Mobility Scooters?

The short answer to this question is “Yes.” Do not get excited just yet because there are strict conditions and an application process required before Medicare considers covering a mobility scooter. It is important to understand that Medicare coverage for mobility scooters is done on a case-by-case basis.

What are the Medicare Scooter Requirements? How to Get a Scooter from Medicare

Your doctor must indicate that you need a mobility scooter for in-home use. Medicare Part B does not cover any costs related to mobility scooters for use strictly outside the home.

Medicare Scooter Application - How to Apply

You must have a face-to-face appointment with your physician that is enrolled in Medicare. The appointment for the purpose of being approved for a mobility scooter involves more than your usual 15-minute doctor's appointment.

What Scooters Does Medicare Cover?

It is important to know what mobility scooters are covered by Medicare before you make a purchase. If you purchase a scooter in advance and Medicare does not cover that particular scooter, you will not receive reimbursement for it.

Medicare Approved Scooter Suppliers

Medicare recently launched an improved supplier directory that helps individuals find suppliers for scooters and other types of covered equipment and supplies. Go to the site page and enter your zip code. There is an optional “equipment” box. Click inside the box and you will get a drop-down list.

Medicare Scooter Evaluation – What is Involved?

There is a required on-site evaluation of the patient’s home performed before or at the time of the scooter delivery. A written report accompanies the evaluation.

Medicare Scooter Reimbursement - How to Get Reimbursed

The supplier sends the claim for the cost of your mobility scooter to Medicare. Some suppliers may require that you pay the entire amount of a scooter upfront and wait for reimbursement.

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.

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.

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.

What is a drive medical bobcat?

This three wheeled scooter is called the Drive Medical Bobcat X3. It’s lightweight and easy to assemble. Plus, it’s very portable which makes it simple to store in your car when you’re on the go. You can adjust the flip-up armrests to what’s most comfortable for you and simply control the scooter with a finger-pull throttle.

How fast is a Pride scooter?

For those who want a scooter that’s easy to take on the go, consider buying the Pride Mobility Go-Go Folding Scooter. It folds in just three steps and can be stored in tight spaces at home or in the trunk of a vehicle. The maximum speed is four miles per hour and it can travel an average of 12.5 miles on one charge.

What is DME medical equipment?

This is a type of health or medical equipment that’s deemed medically necessary by your doctor. The equipment must be used to help you complete day-to-day tasks independently. Only a doctor can prescribe DME for you. Once prescribed, it must meet these five requirements to qualify for Medicare coverage:

Can Medicare help seniors with scooters?

These scooters are designed to get seniors where they need to go, while preventing falls and keeping them stable. It can also encourage people to stay active, even if they’re losing their strength and physical abilities. But if they’re a bit out of your price range, there’s a chance Medicare could help. If you meet certain criteria, Medicare may ...

Can a doctor prescribe a scooter?

Once prescribed, it must meet these five requirements to qualify for Medicare coverage: If your doctor prescribes a scooter as a type of DME , then you’re good to go.

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.

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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…
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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…
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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...
See more on verywellhealth.com

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