Mobility is important for the elderly. The ability to easily move between rooms, cook without assistance or go for a walk on a nice summary day is critical. Without the ability to move freely many elderly feel alone and frustrated.
Walkers, wheelchairs and scooters can help your loved one more safely keep their independence. The financial burden of acquiring these mobility devices can be large however.
Bills pile up. Trips to the grocery store for food, deductibles for doctor’s visits and medications from the drug store cost a lot. Adding on top of that a few hundred (or even a couple thousand) dollars for an automated wheelchair or mobile scooter can be too much. Many families can’t afford it.
I want to empower you to know exactly where to go. I want you to know the steps to get Medicare or Medicaid to pay for your wheelchair or scooter. I want you to know which non-for-profit institutions are willing to give you a hand.
By the end of this article you will feel that you know what options are available to you. You will know exactly what the cost is. You will save hundreds of dollars from your family’s bank account.
Below are the key steps to purchase a wheelchair or scooter through Medicare or Medicaid.
1. Determine If You Are Eligible
Medicare has clear requirements for sponsoring the purchase of a wheelchair or scooter. First and foremost your loved one needs to have difficulty moving around their home as well as completing activities of daily living.
The critical criteria is difficulty moving inside of the home. Difficulty walking outside, driving a car, or transporting between different locations doesn’t count. Medicare is focused on mobility inside the home.
The need is determined by your loved one’s physician. The physician needs to sign a Medicare form (CMN – Certified Medical Necessity document) and define what type of mobility aid is needed. Schedule an appointment with your loved one’s doctor to get the process rolling.
To determine the type of mobility device required Medicare starts with a walker and moves up in level of support provided by the device.
If your loved one can use a walker that is what Medicare will sponsor. If they can’t use a walker a manually powered wheelchair is sponsored. If they can’t power a manual wheelchair with their upper body a mobile scooter is sponsored. If they don’t have enough upper body support to sit up in a scooter an automated wheelchair is sponsored.
Again, the level of support needed is determined by the doctor. Make sure you are present for the doctor’s visit and advocate for your loved one.
2. Define The Cost
Manual wheelchairs cost between $100 and $750. The costs range based on the weight of the wheelchair.
A mobile scooter costs between $600 and $2,000. Their costs range based upon the number of wheels and length of battery charge.
Power wheelchairs cost between $1,000 and $3,500. Their costs range based on speed, turning radius, and battery life.
If the mobility device is approved Medicare will likely cover 80% of the cost. Your loved one will need to pick up the remaining 20%. If you have Medicare Advantage Insurance this may help your family pay some of that 20%.
Remember that if you pay the 20% out of pocket you can get a tax deduction. File these expenses when you do your taxes under “Medical and Dental”.
3. Find A Registered Supplier
Medicare works with specific suppliers for mobility devices. Work through one of these suppliers so you can get the Medicare coverage. The full list can be found here.
Enter your zip code and look for these categories:
- Walkers and Related Accessories
- Wheelchairs & Accessories (Power, Manual, and Rehabilitative)
- Power Operated Vehicles (Scooters)
Change the distance from the zip code from 10 to 25 miles to get a larger search result. You may need to check zip codes nearby as well. They will provide you with the company name, address and contact information.
4. File For A Reimbursement
Many of the approved Medicare suppliers will file your reimbursement claim for you. However in order to do that you need to follow specific steps:
- Provide the company with signed copies of Medicare Supplier Standards, HIPAA Privacy Notice, and HIPAA Authorization Form
- Provide the company the authorized prescription from your physician, copy of your Medicare Card and your date of birth
- Wait for the company to file the claim
- Receive the 80% reimbursement by mail from Medicare
Not all companies follow this exact process but these are the high-level steps.
Now you should be all set for getting a Medicare sponsored mobility device. Well done.
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August 13, 2015
By: JP Adams