Does medicare cover electric mobility scooter?

Mobility scooters and wheelchairs can significantly enhance the quality of life for individuals with limited mobility. However, these devices can be expensive, and many people wonder if Medicare covers their cost. Here’s a detailed guide on how Medicare handles coverage for mobility scooters and wheelchairs.

Medicare Coverage for Mobility Devices

Medicare Part B (Medical Insurance) provides coverage for Durable Medical Equipment (DME), including mobility scooters and wheelchairs, if they are deemed medically necessary by your doctor.

Eligibility Criteria

To qualify for Medicare coverage for a mobility scooter or wheelchair, you must meet the following conditions:

1. Medical Necessity: Your doctor must determine that a mobility scooter or wheelchair is necessary for you to perform daily activities inside your home. This means that you must have a health condition that significantly impairs your mobility, making it difficult to move around your home without assistance.

2. Doctor’s Prescription: A written prescription from your doctor is required. The prescription should explain why a less expensive mobility aid (such as a cane or walker) is insufficient for your needs and why a mobility scooter or wheelchair is necessary.

3. Home Use: The primary use of the mobility scooter or wheelchair must be for mobility within your home. Medicare does not cover devices intended solely for outdoor or recreational use.

4. Supplier Approval: The device must be obtained from a supplier enrolled in Medicare. It’s important to use a Medicare-approved supplier to ensure coverage.
   
   

Steps to Obtain Coverage

1. Consult Your Doctor: Discuss your mobility issues with your doctor. If they determine that a mobility scooter or wheelchair is necessary, they will provide a prescription.

2. Face-to-Face Examination: Medicare requires a face-to-face examination with your doctor to assess your mobility needs. This examination will be documented and included with your claim for the mobility device.

3. Choose a Medicare-Approved Supplier: Work with a supplier that accepts Medicare assignment. This ensures that the supplier will not charge you more than the Medicare-approved amount.

4. Submit Documentation: Your doctor and supplier will submit the necessary documentation to Medicare, including the prescription and proof of medical necessity.
   
   

Types of Covered Mobility Devices

• Manual Wheelchairs: Covered if you have sufficient upper body strength to propel the wheelchair independently.
• Power-Operated Vehicles (Scooters): Covered if you can safely operate the scooter and get in and out of it without assistance.
• Power Wheelchairs: Covered if you cannot use a manual wheelchair or scooter safely and require a power wheelchair to perform daily activities inside your home.
  
  

Costs and Coverage

If approved, Medicare typically covers 80% of the Medicare-approved amount for the mobility device. You will be responsible for the remaining 20% of the cost, as well as any applicable deductibles.

Additional Considerations

• Medigap Plans: If you have a Medicare Supplement (Medigap) plan, it may help cover the remaining costs that Medicare does not pay.
• Medicare Advantage Plans: Some Medicare Advantage plans may offer additional coverage for mobility scooters and wheelchairs. Check with your plan provider for details.

Medicare can cover the cost of mobility scooters and wheelchairs if they are deemed medically necessary and all criteria are met. To ensure you receive coverage, work closely with your doctor and a Medicare-approved supplier. This coverage can significantly enhance your mobility and quality of life, providing you with greater independence.