A Look at Electric Wheelchairs and Medicare
Electric wheelchairs are very expensive and therefore, it can be
a difficult decision whether to buy one. However, Medicare
usually covers up to 80% of the cost of electric wheelchairs.
Any secondary insurance company will usually cover the rest.
To obtain Medicare for electric wheelchairs, certain criteria
have to be met:
1. The person's condition is such that, a wheelchair or scooter
is a must for mobility. 2. The person cannot operate a manual
wheelchair, hence an electric wheelchair or an electric scooter
is required. 3. The person is capable of safely operating the
controls of a wheelchair or scooter. 4. The person can safely
transfer in and out of a wheelchair or scooter. 5. The person
has adequate trunk stability to safely ride a wheelchair or
scooter. 6. The person has not purchased a wheelchair or scooter
and obtained reimbursement for that purchase within the last
five 5 years. 7. Medicare must be the primary insurance carrier
for filing the initial claim with them. 8. If Medicare had
covered the cost of a manual wheelchair previously, that chair
should be returned to the company for claiming the cost of an
electric wheelchair from Medicare.
If all of these criteria are met, then the person seeking
support from Medicare should provide a description of the
functional limitations affecting the patient, which supports the
medical necessity of the POV; patient diagnosis requiring the
POV. This information must be furnished on letterhead or other
documentation, which identifies the specialty of the ordering
physician. The recommendation for a wheelchair for which
reimbursement is requested needs to be ordered by a neurologist,
orthopedic surgeon, rheumatologist, or rehabilitation medicine
specialist.
Medicare supports up to 80% of allowable charges however,
reimbursement amounts vary from state to state. $100.00 is
deductible yearly for Medicare's Part B. All Medicare claims are
settled within 30 days. For guaranteed assurance, it is better
to fill out a pre-approval form from Medicare.