Does Medicare Pay For Electric Wheelchairs?
A lot of families wind up asking this question at some point, and the answer is yes, Medicare may assist pay for an electric wheelchair, but there are certain crucial requirements that must be met.
A power wheelchair is what Medicare commonly calls an electric wheelchair. If it is deemed medically essential, Medicare Part B may cover one. The last component is the most important. Medicare probably won’t approve a power wheelchair merely because it would make it simpler to go shopping, go out, or get around outside. Most of the time, the wheelchair is needed so the individual can securely move around in their own house.
When Medicare Might Help Pay for It
Medicare usually wants to see that someone has a health problem that makes it hard for them to walk or move about at home. It also checks to see whether additional mobility aids would work. If a cane or walker isn’t adequate and a manual wheelchair isn’t a good alternative because the individual can’t operate it safely or well, then a motorized wheelchair could be a possibility.
A doctor or other trained healthcare professional usually has to check on the patient and write down why the wheelchair is medically essential. There also has to be a signed order, and the seller of the equipment must be a Medicare participant. Medicare may also demand prior authorization before it would pay specific models of electric wheelchairs in some cases.
What Will the Person Still Have to Pay?
Just because Medicare approves the wheelchair doesn’t mean it’s free. Most of the time, the person has to fulfill the Part B deductible before Medicare Part B pays for anything. After that, Medicare usually pays 80% of the authorized amount, and the patient is usually responsible for the other 20%, unless they have other insurance that helps pay for that amount.
That’s why it’s a good idea to ask questions before you buy something. Families frequently think that Medicare will pay for everything, but then they are surprised by the costs they have to pay themselves. It’s also a good idea to check that the supplier takes Medicare assignment, as it might change how much the patient has to pay.
Why Medicare Doesn’t Approve Everything
This is where some people become angry. Medicare doesn’t automatically accept every request for an electric wheelchair. The paperwork has to prove that there is a true medical need and that the requirement is related to everyday living in the house. Medicare is more concerned with whether the person can safely move around their house than if the wheelchair would be beneficial in general.
Let’s Get Moving
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References
https://www.medicare.gov/coverage/wheelchairs-scooters
https://www.medicare.gov/coverage/durable-medical-equipment-dme-coverage
https://www.medicare.gov/coverage/wheelchairs-scooters/power-wheelchairs-prior-authorization
https://www.medicare.gov/publications/11046-medicare-coverage-of-wheelchairs-scooters.pdf
https://www.medicare.gov/publications/10116-your-medicare-benefits.pdf