Medicare Mobility Scooters and Other Mobility Devices

You may be aware that Medicare covers mobility scooters and other mobility devices for people who qualify. Following is information to help you determine whether you may be one of those who meet the qualifications for a Medicare-covered scooter or powered wheelchair.

Durable Medical Equipment

As far as Medicare is concerned, mobility scooters and powered wheelchairs fall under the category of Durable Medical Equipment (DME). Other items falling under this category include:

Air fluidized beds
Blood glucose monitors
Canes (other than white canes for the blind)
Commode chairs
Crutches
Home oxygen machines and supplies
Hospital beds
Infusion pumps and some medicines used in them
Lymphedema pumps/pneumatic compression devices
Manual wheelchairs
Nebulizer sand some medicines used in them (if reasonable and necessary)
Patient lifts (to help move a patient from a bed or wheelchair)
Suction pumps
Traction equipment
Ventilators or respiratory assist devices
Walkers

For a more complete list of DME items Medicare covers, consult the Centers for Medicare & Medicaid Services (CMS) booklet, Medicare Coverage of Durable Medical Equipment and Other Devices.

What Medicare covers

Medicare Part B will help pay for a mobility scooter that is deemed medically-necessary. The Medicare Part B deductible applies. Once the Part B deductible—currently set at $147 annually—is met, Medicare Part B covers 80% of approved costs. Under Original Medicare Part A and Medicare Part B, remaining costs must be paid out-of-pocket. If you are enrolled in a Medicare Advantage plan, the same items of durable medical equipment are covered under your plan as under Original Medicare. Medicare Advantage plans are required to cover the same items that Original Medicare covers, including DME. However, cost obligations under Medicare Advantage can vary, so you should check with your Medicare Advantage plan about costs and rules associated with purchase or rental of your mobility scooter or powered wheelchair. Under some Medicare supplement plans, out-of-pocket costs associated with purchase or rental of mobility assistive devices may be eliminated altogether. Medicare supplement (or Medigap) Plan F, for example, covers all Medicare-approved costs not covered by Medicare Part A and Medicare Part B, and will eliminate deductible and coinsurance costs associated with purchase or rental of medically-necessary durable medical equipment.

How is medical necessity determined?

Your doctor or treating practitioner must determine that a particular item of DME is required for your use at home, and must prescribe the item for you to use at home. If you require the item only for use outside the home, it will not be covered by Medicare.

To qualify for a Medicare-covered mobility scooter or powered wheelchair, you will need a medical examination. Your doctor must certify in writing that you need the device to perform your daily functions at home. Simply having difficulty dressing, bathing, or getting out of bed is not enough. If you are able to perform functions of daily life at home while using a cane, a walker, or a standard wheelchair, you will not qualify for a Medicare-covered mobility device.

Does Medicare cover the cost of purchasing a mobility vehicle, or just rental?

For most types of durable medical equipment, Medicare pays rental costs. With regard to mobility devices, Medicare beneficiaries usually have the choice of renting or purchasing equipment that is medically-necessary.

However, rental costs paid by Medicare normally cannot exceed the price of purchase. As a result, purchase is usually the better option.

If a Medicare beneficiary chooses the rental option for a Medicare-covered powered wheelchair, Medicare will make rental payments for 13 months. After 13 months, ownership of the device is transferred to the beneficiary.

For more information about Medicare coverage of scooters and other power mobility devices, check out the CMS booklet, Medicare Coverage of Power Mobility Devices (PMDs): Power Wheelchairs and Power Operated Vehicles (POVs).

Suppliers

Medicare covers only durable medical equipment purchased or rented from a supplier enrolled in the Medicare program. In order to qualify for a Medicare supplier number, a supplier is held to strict standards, and Medicare will not pay for DME that has come from a supplier that has not been issued a Medicare supplier number. Therefore, it is imperative that you ask any supplier for their Medicare supplier number before you consider renting or purchasing any item that you expect Medicare to cover. This applies regardless of whether the supplier is a small business or a large chain store. CMS advises: “To find a supplier that is enrolled in the Medicare program, visit www.medicare.gov and select ‘Find Suppliers of Medical Equipment in Your Area.’ You can also call 1-800-MEDICARE (1-800-633-4227) to get this information. TTY users should call 1-877-486-2048.”

Always make sure that your supplier accepts assignment. Accepting assignment means the supplier accepts Medicare’s terms and will accept the Medicare-approved amount as full payment. The Medicare-approved amount is the maximum amount Medicare has set for the rental or purchase of an item, and no supplier that accepts assignment can charge more than this amount.

For further information about Medicare and mobility assistive equipment, check out the CMS booklet, Medicare’s Wheelchair and Scooter Benefit. To learn more about Medicare Advantage, Medicare supplement insurance, and all your best healthcare options, contact MedicareMall and let us save you money and lead you with confidence through the Medicare maze!