As seniors age it’s common for many to experience a reduction in mobility, often caused by conditions like osteoarthritis, decreased muscle mass, osteoporosis, reduced vision, and balance issues. Statistics show that seniors who lose mobility typically don’t continue living at home, but they move into assisted living or nursing facilities. They also have an increased risk for illness, disability, hospitalization, and a lower quality of life in general. Thankfully, innovations in mobility devices, such as scooters, have made aging in place an option for many seniors facing mobility issues.
These days, people who are living with mobility problems can use a mobility scooter to get around. Mobility scooters are like motorized wheelchairs because they are electrically powered, but scooters are usually less expensive, easier to modify, and easier to transport. These mobility scooter features give users more independence to move around, and they don’t need as much body strength or stamina to operate them.
There are many different types of mobility scooters available on the market today. It’s not difficult to find one to fit your needs and your budget. And another great thing about mobility scooters? Medicare insurance may help cover scooters for those who are eligible. Here’s a look at how Medicare can help you get a mobility scooter.
Do your Medicare benefits cover a mobility scooter?
Fortunately, your Medicare Part B coverage does pay for a portion of the cost to rent or purchase a mobility scooter if you meet the eligibility requirements. This benefit falls under Medicare coverage for durable medical equipment – supplies or equipment that your physician prescribes for you to use in your place of residence.
To be eligible, your health care provider must examine you face-to-face and write a prescription certifying that the scooter is medically necessary. Medicare defines medically necessary services or supplies as those needed to diagnose or treat illness or injury, a condition, disease, or any symptoms that are within the accepted standards of medicine.
Also required for this benefit, your prescribing physician and the supplier of the durable medical equipment must accept Medicare assignment or Medicare won’t accept your claims.
Depending on the type of equipment, Medicare Part B covers the rental or purchase of the device. In some instances, you may have the option to do either. If the supplier accepts Medicare assignment, he can only charge the Part B coinsurance and your Part B annual deductible for the final approved amount for monthly rental or the purchase price.
Original Medicare Part B pays 80 percent of the approved amount, and you pay the remaining 20 percent after you’ve met your annual Part B deductible.
In certain cases, Medicare may require that you get prior authorization, depending on the type of power scooter you get. In this instance, your durable medical equipment supplier should make a request for the prior authorization and send it, along with all necessary documents to Medicare. For this step, you don’t have to do anything. Your health care provider and your supplier take care of the necessary paperwork for you. If the authorization is denied because Medicare doesn’t have enough information or it finds medical necessity is lacking, your supplier can resubmit a bid for authorization.
Do Medicare Advantage plans cover mobility scooters?
Whatever benefits are covered by Original Medicare Parts A and B, Medicare Part C plans are required by law to cover them also. However, your plan may require that you use specific health care providers, physicians, medical facilities, and medical suppliers that it lists on its network of providers. You may not get coverage if you go outside the network, depending on your plan.
If you aren’t sure about your plan’s requirements, you should call and ask for details before making any appointments, renting, or purchasing a mobility scooter.