Medicare Coverage for Medical Walkers

Understanding Medical Walkers

Medical walkers can be much more complicated than people may think. Walkers are not like canes or crutches where it can be a little more natural to understand how to use them. When someone needs a walker, they are encouraged to have a therapist show them how to properly use the walker. The kind of walker that you get depends on your condition and your needs. When you are in the hospital or a nursing facility, you are normally given a walker to use while you are at the facility. In that instance, there is usually no cost for having the walker at your disposal. But if you need a walker when you are at home or moving around from place to place, then there is a long list of guidelines that your doctor must follow before your walker can be covered by Medicare.

Does Medicare Cover Medical Walkers?

As long as your doctor follows the guidelines, and you have Medicare part B coverage, then any costs associated with a medical walker will be covered by Medicare up to 80 percent after your deductible has been paid. One of the ways that you can keep your out of pocket costs down is to invest in Medicare gap insurance. This is insurance that will pay your 20 percent co-payment for you in most cases. As long as you stay within the guidelines of your insurance provider's terms, then you may have no out of pocket expense for your walker. But the first step in the process begins with a thorough examination by your doctor.

Will Medicare Pay for my Medical Walker?

When you are trying to get Medicare to pay for a mobility device such as a medical walker, then your doctor needs to submit a piece of paperwork known as a certificate of medical necessity. This outlines the exact reason why you need the walker, why there is no other alternative to it and how long your doctor expects you to have to use the walker. In this report, your doctor will outline your exact condition and explain in great detail why you need the walker. Before Medicare will approve the walker, your doctor needs to indicate that it will be used repeatedly to assist in mobility and that it is not going to be used to try and prevent injury. Another stipulation is that you need the walker to get from one room to another inside your home. The walker can be used outside the home, but you must need it to move around inside your home and not just for outside use.

Do not assume that you will be able to purchase a walker on your Medicare insurance without the approval of your doctor. You cannot have Medicare pay for your walker without your doctor's examination and approval from Medicare. Once you receive those two items, then you can look for a supplier that will help you get a medical walker.

Types of Medical Walkers

There are two primary types of walkers; the standard foldable walker and the walker with wheels. A foldable walker can be folded into a flat shape that can easily fit in a car or stored in some way. The wheeled walker has wheels and handbrakes on it to help make mobility easier. People who weigh more than 250 pounds, have a severe neurological condition that impedes coordination or can only use one hand to operate a walker will be issued a special walker that can help compensate for these conditions.

How to Qualify for a Medical Walker?

Your doctor is going to confirm that you have the proper body strength to be able to use a walker. The walker should be able to assist you with mobility and not just be something you use to hold yourself up. If your body is too weak to stand and move using a walker, then your doctor may insist on a wheelchair. The wheeled walker is used for people that have sufficient upper body strength, sufficient hand strength to use the brakes and the proper coordination to use a walker with wheels but lack the sufficient leg strength to move their body forward effectively. You need to be able to stand on your legs to use a walker with wheels, but the wheels can act as your primary mode of locomotion. Once again, if your legs are too weak to use a wheeled walker, then your doctor may recommend that you use a wheelchair.

Medicare Approved Medical Walkers Suppliers

Medicare suppliers come in two forms; participating suppliers that accept pricing assignments and participating suppliers who do not accept pricing assignments. The best choice is to find one that will accept assignments because that means that the supplier will not charge any more than the Medicare-approved maximum for your walker. That allows you to use your gap insurance or keep your co-payment costs down if you do not have gap insurance. If you use a participating supplier that does not accept assignments, then that supplier is allowed to charge up to 15 percent more than the Medicare-approved maximum. That means that your co-payment will be higher and your gap insurance may not cover the higher co-payment.

You can usually get a good Medicare supplier referral from your doctor. He should have the contact information for a medical supplier that is a Medicare participant that accepts assignments. If your doctor cannot help you, then just look for medical suppliers in the phone book and call them until you find one that accepts Medicare pricing assignments.