Many Americans suffer from mobility issues, making it difficult to take care of normal daily activities like running errands and visiting with family and friends. Thankfully, electric wheelchairs are available to assist you in moving around, and today’s electric wheelchairs are more durable and powerful than ever, allowing users to travel for longer periods of time between charges.
Seniors and individuals with disabilities often need electric wheelchair technology the most, but for some, and those who receive Medicare benefits may question whether or not an electric wheelchair will be covered by their insurance.
Does Medicare Cover Electric Wheelchairs?
In the past, Medicare recipients facing mobility challenges were able to access electric wheelchairs through Medicare with relative ease. Unfortunately, some suppliers began to take advantage of the Medicare program for financial gain. A few companies resorted to dubious billing practices and the lobbying of medical professionals to prescribe electric wheelchairs for patients who may have been able to gain mobility through less expensive means. As a result, Medicare began to crack down on access to motorized scooters and electric wheelchairs, making the process of obtaining coverage through Medicare a bit more challenging in some cases.
Electric wheelchairs, as well as manual wheelchairs, may be covered by Medicare Part B (Medical Insurance). Medicare Part B helps cover the costs of medically necessary services and supplies, including outpatient procedures and durable medical equipment (DME). In order for Medicare to help cover the cost for an electric wheelchair, the device must be intended to be used in the patient’s home and must be ordered by your physician who deems it medically necessary. Individuals who may need an electric wheelchair must receive an in-person medical evaluation by a Medicare-approved physician, and the wheelchair must be rented or purchased from a Medicare-approved supplier.
How Much of the Cost Does Medicare Cover?
In most cases, Medicare recipients who are prescribed electric wheelchairs will be responsible for 20% of the cost of the device. If paying out of pocket, you have the advantage of purchasing from any manufacturer or supplier, but keep in mind that you will be responsible for the full cost of the electric wheelchair and related supplies. Individuals enrolled in Medicare Advantage plans may receive additional discounts or coverage options when compared to original Medicare Part B coverage, so if you have such a plan, you will want to discuss the specifics with your plan’s benefits advisor.
Alternatives to Electric Wheelchairs
It’s also important to keep in mind that you may not be able to receive a prescription for an electric wheelchair, at least initially, if other mobility solutions are available. Your physician or specialist may feel that purchasing an electric wheelchair for a temporary medical condition affecting your mobility is unnecessary, although renting an electric wheelchair may be a solution for short-term use. In other cases, you may be prescribed crutches or other mobility equipment until the condition has resolved.
You may also need to undergo physical therapy as part of a treatment plan to address your mobility concerns. For some individuals, physical therapy can help resolve your mobility condition. Of course, every situation is unique, and only you and your physician can determine the right course of action to help you regain or retain mobility.