Wheelchair Archives - Mobility Center

According to Medicare.gov, Medicare Part B (Medical Insurance) does cover power-operated vehicles (scooters), as well as manual wheelchairs when prescribed by a doctor for home use. If you choose to rent either a scooter or wheelchair, ownership will transfer to you after 13 months.

Before Medicare helps pay for the wheelchair, you must meet face-to-face and receive a prescription from a doctor or other treating provider.

Talk To Your Doctor About Wheelchairs First

You will need to have a face-to-face examination with your doctor prior to getting a scooter or wheelchair. At this time, your doctor will determine the type of mobility aid you need and write a prescription. Make sure to ask your doctor which types of scooters or wheelchairs may be best for your situation.

Buying Vs Renting Wheelchair With Medicare

Always ensure the mobility aid you have been prescribed is ideal for your physical needs. Your doctor should take any health issues into account. The company you purchase the wheelchair from should perform a home assessment to make sure your wheelchair will work in the necessary space.

The size needs to be a good fit for your weight and height, with comfort being paramount. If you choose a rental wheelchair, ownership transfers to you after 13 months, as stated above.

Original Medicare Costs

If your supplier happens to accept assignment, you will be responsible for paying 20% of the Medicare-Approved Amount. The Part B deductible does apply here. Medicare will pay for different types of durable medical equipment (DME) in different ways.

DME factors affecting Medicare coverage include:

Rent the equipment.
Buy the equipment.
Being able to choose whether to buy or rent the equipment.

Medicare only covers your medical equipment if your doctor and medical supplier are currently enrolled in Medicare. In order to stay enrolled in Medicare, both doctors and suppliers are required to meet strict standards. Medicare will not pay claims submitted by doctors and suppliers who are not enrolled in Medicare.

Make sure you know ahead of time if both your doctor and supplier is enrolled in Medicare before moving forward with this process. Participating suppliers must meet assignment, which means they can only charge the patient for coinsurance and the Part B deductible for the amount approved by Medicare. There’s essentially no limit on what suppliers can charge you if they are not participating in Medicare.

Medicare Approvals And Denials

In September of 2018, it was ruled that you must get “prior authorization” for different types of power wheelchairs. 40 types of power wheelchairs require this prior approval. Check out that list right here. Prior authorization is needed before Medicare approves covering the cost of the wheelchair.

DME suppliers need the following for approval:

Request prior authorization ahead of time.
Send request and other required documentation to Medicare.

The good news is the patient typically doesn’t have to do anything in this scenario. All the work is on the supplier at this point. Your DME supplier is responsible for the authorization request and sending all documentation to Medicare on your behalf. Medicare will then review the request and documentation to make sure you are eligible for coverage.

Prior authorization could be denied based on the following:

Medicare finds that you do not medically require use of a power wheelchair.
Medicare does not receive sufficient documentation to make an approval.

How Much Do Wheelchairs Cost?

There are three main types of wheelchairs: transport, manual and electric. Depending on the type of wheelchair needed, costs can range all the way from $90-$9,000, with an average price of $4,455. Of course, prices will vary based on model, with transport being the least expensive and electric being the most expensive of the bunch.

Transport Wheelchair Cost:

Price range: $90-$2,000
Average cost: $955

Manual Wheelchair Cost:

Price range: $200-$3,000
Average cost: $1,400

Electric Wheelchair Cost:

Price range: $1,500-$9,000
Average cost: $3,750

How Much Do Mobility Scooters Cost?

When searching through the top mobility scooter providers, the average costs range from as low as $299 to as high as $9,000. Depending on the model and quality, customers can expect to pay $4,350 on average for a new scooter, according to Theseniorlist.com.

Other Medicare Considerations

Medicare will only cover one wheelchair at a time, with one replacement covered every five years (excluding some limited circumstances). Medicare will also cover repairs. If you are renting, the repairs will already be covered as part of the rental agreement. Battery replacements will be covered by Medicare, if needed.

Mobility Center In Mesa, Arizona

Mobility Center has been proudly serving the entire Phoenix, Arizona area since 1975 with the finest in mobility aids, scooters, wheel chairs, lifts and support equipment. Visit our convenient location to see the products and receive the individual attention that you deserve. Our service area includes Mesa, Apache Junction, Tempe, Chandler, Scottsdale, Phoenix, Glendale, Surprise, and Sun City.

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