Durable Medical Equipment

Power Chairs and Scooters Meeting DME Guidelines
Written by Nancy McMahon   
Power wheel chairs and scooters are considered mobility assistive equipment just like canes, crutches, walkers and regular wheel chairs.

These devices are highly sought after by those who have a problem walking or getting around their home. Medicare will help pay for a power chair or scooter if you meet Medicare guidelines and the paper work is filled out correctly.

Medicare Requirements For Qualification

Wheelchair and Scooter Benefit has several rules and regulations that must be met. In order to be approved for this benefit, your doctor must fill out the proper forms and specify that you need this type of durable medical equipment because of your medical condition.

Power chairs and scooters fall under the same guidelines as any mobility assistive equipment, or MAE. Mobility assistive equipment includes walkers, manual wheelchairs, canes, crutches, power wheelchairs and scooters.

Before being considered for any of these devices it must be established that you need the device when in your home. You can’t get one if you only need the devise when you are outside the home.

Eligibility for any MAE is based on the subsequent requirements:
  • First you have to have a health condition that requires you to have assistance with the activities of you daily life. This could be bathing, dressing, moving around, getting in and out of bed, or help using the bathroom.
  • You must be able to get on and off the wheelchair or scooter.  You have to have good vision. This can be with corrective lenses or glasses.
  • You must be mentally able to utilize a power chair or scooter in the correct manner and in a safe way. Or you must have someone with you who can make sure the equipment is used safely.
  • The power chair or scooter must be able to be used within your home. The physical layout must not be too small or blocked by stairs and walls that would prohibit you from using the equipment.
The first step is getting a manual wheelchair if you can’t use a walker or cane in a safe manner. There are guidelines for getting a manual wheelchair. These guidelines include the size, what it is made out of, and if it can be rented first or not. Make sure and check with Medicare on these guidelines.

If you need more support than a wheelchair, you may be approved for a rolling chair or Geri-chair. These types of chairs have small wheels. The Medicare guidelines require the wheels to be at least five inches in diameter. The rolling chair must meet the needs of a specific impairment or illness.

Power-Operated Vehicles and Scooters might be approved if you can’t use a walker or cane, or if you don’t have enough strength to operate a wheelchair manually. A motorized wheelchair might also be approved if you don’t have the right set up or space to use a manual wheelchair in your home. A motorized wheelchair might be required if you don’t have the strength to hold yourself on a scooter and worth the controls safely.

Before being approved for any power scooter or motorized wheelchair you must have a doctor fill out the form and explain to Medicare why you need the equipment. The doctor will have to assure Medicare that you are able to operate the motorized device in a safe manner.

The doctor must explain your medical need for the power wheelchair or scooter. This type of durable medical equipment will not be covered by Medicare if it will be used primarily for recreational or leisure activities. It will not be approved if it is primarily need for you to get around outside of your home.

Medicare Benefits If Approved For A Power Chair or Scooter

Medicare Benefits are always changing, so make sure you understand the current requirements, and what benefits are provided by Medicare.

At this time, if you have met the qualifications, you can either rent or buy a power scooter or wheelchair. If you don’t need one long-term, renting might reduce your out of pocket expenses. Discuss this option with the supplier and check with Medicare.

In early 2010, Medicare payments for a power wheelchair or scooter cover 80% of the Medicare-approved amount. This means that you have to first pay the Part B deductible and then pay the remaining 20% of the Medicare-approved amount.

Fraud

Medicare makes a concentrated effort to ensure that people who get a power wheelchair or scooter qualify. There are companies that make false claims and promise consumers that Medicare will cover the cost of the devises when a person wouldn’t qualify. It is important to be careful and not accept delivery or make any payments until Medicare has approved the motorized devise.
 
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