Many people are confused about whether their Medicare benefit will cover their powerchair or scooter, how they can qualify for such coverage, and what that coverage will be. In this article, we will attempt to answer some of the frequently asked questions regarding this issue with clear, no-nonsense answers. Hopefully, by the end we will have addressed any concerns or questions you personally may have, but if we haven’t, please feel free to contact us at (760) 471-8884 and we will be happy to assist you! At Pacific Mobility Solutions, we are a family owned and local business and we value our customers’ satisfaction. In fact, we guarantee it!
What are the Requirements for Medicare Coverage?
In Medicare terminology, a scooter, powerchair, or manual wheelchair is referred to as “Mobility Assistive Equipment”. There are several different categories: Manual Chair, Rolling Chair, Power Scooter, and Power Wheelchair. Each category has different requirements, but before we get into that, let’s first address the common requirements for all categories.
To qualify for any of the categories, you must meet all the following conditions:
First, you must have a medical/health condition that prevents you from moving without difficulty inside your home. Second, you must be unable to perform normal living activities such as dressing, bathing, getting in or out of chairs or other furniture, even with the aid of a crutch, cane, or walker. Third, you must either be able to safely operate the equipment yourself or have someone who is always available to assist you in the usage of the equipment. The equipment must also fit and be able to be operated safely inside your home, but at Pacific Mobility Solutions we offer a broad array of options and accessibility accessories such as ramps and stairlifts, so we can help with this issue. Finally, it’s important to note that unfortunately you will only qualify for the benefit if the equipment is needed inside your home, and not purely for outside-the-home movement or recreational purposes. Now let’s discuss the individual category requirements and definitions.
Manual Wheelchairs are regular, non-powered wheel chairs with large rear wheels and smaller front wheels. You may qualify for a manual wheelchair if you can’t use a cane or walker safely. Not all manual wheelchairs qualify for this benefit. Please contact us at (760) 471-8884 for assistance choosing one that is covered. We will be happy to help!
Rolling Chairs are non-powered chairs that offer more support and comfort. Their rear wheels are smaller but at least 5” in diameter. You may qualify for one of these if you medically require more support than is provided by a manual wheelchair. The chair must be designed to meet your particular medical need or condition.
Power Scooters are three- or four-wheeled powered vehicles with a chair that generally are controlled with handlebars much like a bicycle. You may qualify for a power scooter if you cannot use a cane, walker, or crutches safely and are unable to operate a manual wheelchair.
Power Wheelchairs, or Powerchairs are generally chairs mounted on four or six wheels that are controlled by a joystick and have the ability to turn in small or zero radius. You may qualify for a powerchair if you cannot sit up or operate the scooter controls safely, or if you cannot safely use a manual wheelchair in your home.
For all categories, you must have your doctor verify your medical need for the equipment. In the case of power equipment, your doctor must examine you in person and verify that you have the ability to operate the equipment safely. Your doctor must then submit an order to Medicare verifying and explaining your need for the equipment and your ability to use it safely.
Once this has been determined, the next question you may have is how much of the cost of the equipment Medicare will cover.
What Share of the Cost Will Medicare Cover?
This is a very common question and concern shared by many people. Mobility Assisitive Equipment is covered under Medicare Part B. Generally, once you have met your Part B deductible, Medicare will cover 80% of the Medicare-approved cost, leaving 20% for you to cover. If you have private insurance, it may cover part or all of the 20%, meaning you may be able to get the equipment for little or no cost. You should contact your insurance provider for more information regarding their coverage. It is important to note that at Pacific Mobility Solutions we offer the widest selection and lowest prices, guaranteed. We can work with many budgets and needs are always willing to help you. Also, Pacific Mobility Solutions is a Medicare-participating supplier, which means we are approved by Medicare to supply your mobility needs. Now you are ready to pick out your equipment.
How Do I Know What Chair is Right for Me?
At Pacific Mobility Solutions, we offer a broad range of equipment from manual chairs all the way up to top of the line, state of the art powerchairs. We know knowing which category of equipment you qualify for and which model is right for you can be confusing. That’s why we are here to help. We offer many floor models for testing with free test rides, and our friendly, knowledgeable, and factory-trained staff are always available to assist you in carefully choosing the right chair for you. We will help work with your doctor and Medicare to determine what type of equipment you qualify for, and which model will best suit your needs and budget. Please contact us at (760) 471-8884 with any questions you may have, to schedule an appointment, or just drop on by. At Pacific Mobility Solutions, we are your locally and family owned and operated , Medicare approved source for all your mobility needs. Please come see us to experience what a difference personalized service, friendly and knowledgeable staff, and that family touch can make for your sales and service experience.
Still on the fence? We also rent a variety of equipment including manual chairs, power chairs, and travel scooters. You may be able to rent the equipment first before you buy to try it out for a longer period.
Hopefully this has answered your questions and addressed any concerns you may have. If not, for more information, or to schedule an appointment, please call us at (760) 471-8884. At Pacific Mobility Solutions, we put our customers first and guarantee satisfaction 100%. Call or come in today reclaim your mobility!
This information is being provided for informative use only and should not be considered medical or legal advice. For medical or legal questions, please contact your doctor or attorney. For more info about Medicare’s benfits and requirements, please refer to www.medicare.gov and specifically http://www.medicare.gov/Publications/Pubs/pdf/11046.pdf
President, Husband, Father, Grandfather Graduate of UC Davis- Bio Sci Major- Go Aggies! Jeff has extensive experience in all of Pacific Mobility’s products and services, and specializes in accessibility products as well as stairlifts, ceiling lifts and custom wheel chairs. His hobbies include spending time with family, gardening, mountain biking, exercising and off road motorcycle riding.
24 years as Owner/President of Pacific Mobility Center – selling, installing, and servicing stairlifts, porch lifts, ceiling lifts, pool lifts, handicap ramping, specialty wheelchairs, scooters, power wheel chairs, and other power mobility devices
Certified Environmental Access Consultant since 2008
Licensed General Contractor since 1998
Certified Aging in Place Specialist since 2016
Board Member for Home Access Professionals
Member of Association of Members of the Accessibility Equipment Industry (AEMA)