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Medicare Info

Will Medicare Pay For My Mobility Equipment?

Being reimbursed by Medicare is a very lengthy and complicated process. Their requirements for eligibility are quite extensive, and you could be waiting around for months for an answer from them. If you are unable to pay the full amount of your mobility equipment, we recommend you pay in installments over time by selecting “Shop Pay” at checkout. 

Below is a list of things to keep in mind when trying to get reimbursement from Medicare. If you’re still confused, we strongly suggest you give Medicare a call to clarify any information. 

Medicare Phone Number: 1-800-633-4227

Important things to consider before using Medicare for reimbursement:

1.) Sometimes, you may need a doctor's prescription in order to be reimbursed for the equipment. Please ask Medicare if that's the case for your situation.

2.) If approved, Medicare Part B usually covers up to 80% of the cost of the equipment, but in some cases, they may cover all of it. 

3.) Although we do not accept direct payment from Medicare or any other insurance, we can offer itemized receipts and medicare billing codes upon request to help with the reimbursement process. Simply send us an email at info@restoremobility.com or call us at 800-971-5369 to let us know you will be requesting that info after you purchase.

4.) Medicare and other insurance will often only cover certain models of scooters and wheelchairs. Please call Medicare first to make sure the item that you are buying is Medicare approved.  

Other Important Information

Getting A Prescription

One of the initial steps in obtaining a mobility scooter is securing a prescription from a healthcare provider. The prescription serves as crucial documentation, demonstrating the medical necessity of the scooter. It should outline your specific condition, the challenges you face, and the essential role the mobility scooter plays in enhancing your mobility and overall quality of life.

How to Get Help from Medicaid

If you're eligible for Medicaid, you have a potential pathway to acquire a mobility scooter. The process typically involves a doctor's prescription and adherence to your state's specific Medicaid requirements. It's essential to communicate with your state's Medicaid office to gain in-depth insights into the application process and ensure you meet all criteria.

Mobility Scooters Covered by Medicare

Medicare Part B offers coverage for medically necessary mobility scooters. However, not all scooters make the cut. To qualify for Medicare coverage, the scooter must align with specific criteria. It should meet designated specifications and weight capacity requirements. Communicating with Medicare is vital to navigate the application process smoothly.

Will Medicare Pay for a Mobility Scooter

Medicare typically shoulders up to 80% of the cost of a Medicare-approved mobility scooter, leaving the remaining 20% as the individual's responsibility. To unlock this coverage, the mobility scooter must be deemed medically necessary by a healthcare provider. Eligibility criteria relating to mobility issues are essential for a successful application.

Lightweight Scooters that are Medicare Approved

While Medicare places emphasis on the medical necessity and suitability of mobility scooters, lightweight options may be approved if they meet specific criteria. Lightweight scooters can be more portable and easier to transport, making them a preferred choice for some individuals. Discussing the suitability of such scooters with your healthcare provider and Medicare themselves can help you explore this option.

How Do You Qualify for a Mobility Scooter

Qualifying for a mobility scooter hinges on several factors. You should have a documented medical condition that significantly impedes your ability to walk or move around. The first step is obtaining a doctor's prescription, which highlights the medical necessity of the scooter. Additional criteria, particularly those related to the scooter's specifications, may differ depending on whether you're seeking Medicaid or Medicare assistance. A collaborative effort with healthcare professionals and your insurance company is paramount to ensure compliance with all eligibility and criteria requirements.

Power Chairs Covered by Medicare

Medicare Part B covers power wheelchairs as durable medical equipment when they are medically necessary for a beneficiary to perform daily activities within their home, as confirmed by a doctor's prescription. These medicare covered power wheelchairs may require "prior authorization" before Medicare approves and pays for them, ensuring that the provided equipment meets specific criteria for medical necessity. Beneficiaries need to obtain their power wheelchair from a Medicare-approved supplier that agrees to accept assignment, which can help control out-of-pocket costs.

Manual Wheelchair Coverage

Medicare provides coverage for the rental or purchase of a manual wheelchair when it is deemed medically necessary. This essential coverage ensures that individuals have access to the mobility equipment they require to support their daily activities and independence, emphasizing Medicare's commitment to providing wheelchairs and meeting the diverse needs of beneficiaries with mobility challenges.

Furthermore, beneficiaries should consult with their healthcare provider to determine the specific requirements and documentation needed to qualify for Medicare coverage of a manual wheelchair. Understanding the process and fulfilling the necessary criteria can facilitate a smoother experience in obtaining the essential mobility aid through Medicare, ultimately promoting the well-being and quality of life for individuals with mobility limitations.

This coverage extends to various types of manual wheelchairs, such as standard, lightweight, and heavy-duty models, based on the beneficiary's specific mobility needs and functional abilities. Additionally, Medicare may also provide coverage for accessories and options that are medically necessary for the effective use of the wheelchair, ensuring that beneficiaries have access to comprehensive support for their mobility requirements.

Rollator Coverage

Rollators are often covered by Medicare when deemed medically necessary. These mobility aids provide essential support and stability for individuals with limited mobility, offering features such as seats, baskets, and hand brakes. Medicare Part B typically covers durable medical equipment, including rollators, as long as they are prescribed by a healthcare provider to assist with a medical condition.

Similarly, upright walkers, which have gained popularity for promoting better posture and reducing strain on the back, shoulders, and neck, may also be covered by Medicare if deemed medically necessary. As with rollators, Medicare Part B may cover upright walkers as durable medical equipment if a healthcare provider deems them essential for the individual's medical condition.

Adjustable Bed Coverage

Adjustable beds and their Medicare coverage can vary greatly, but we are here to simplify it for you. These beds allow users to modify the position of the bed for comfort and health reasons, and can be covered by Medicare under certain conditions. These beds are often considered durable medical equipment (DME) when prescribed by a doctor, and therefore, may be included in Medicare Part B benefits. Similarly, sleep-to-stand lift beds, designed to assist individuals in transitioning from lying down to a standing position, can also qualify for coverage if deemed medically necessary. It is crucial for beneficiaries to obtain a prescription from a healthcare provider and to work with a Medicare-approved supplier to ensure that the costs for these therapeutic beds are covered under their Medicare plan.

Lift Chairs Covered by Medicare

Lift chairs, which are essentially recliners with a motorized lifting mechanism to assist individuals in standing up from a seated position, can be partially covered by Medicare under certain conditions. Medicare Part B may cover the cost of the lifting mechanism within the chair if prescribed by a doctor for a patient with specific medical conditions that impede mobility. The coverage typically does not extend to the full cost of the chair, but rather to the lift mechanism that is considered durable medical equipment (DME). It's important for beneficiaries to understand the coverage criteria and their own responsibilities for any remaining costs.