Medicare Coverage for Wheelchairs

Qualifying for a Wheelchair

When you start to discuss wheelchairs, you need to break the discussion down to electric and manual wheelchairs. Many people may not realize this, but there is a comprehensive series of tests that your doctor must perform before you can be approved to have an electric wheelchair paid for by Medicare. The determination of which wheelchair you qualify for is one that can only be made by your doctor. So you should avoid making any wheelchair purchases until you have spoken with your doctor and you know what kind of chair you qualify for.

Manual Wheelchairs

Manual wheelchairs can either be collapsible or have rigid frames. The collapsible wheelchairs are much easier to transport but have a predetermined weight limit. The rigid framed chairs are used for larger people that require additional support. The rigid frames can be folded to a certain extent to make travel easier, but they are made of light-weight metal tubing that makes them larger and requires a larger vehicle to transport them.

A manual wheelchair is given primarily to two types of people. The first group is the people that can operate the chair on their own and have the upper body strength to move the chair and control its movements. These patients do not require anyone to help them get around in their wheelchair, and they also do not require the additional assistance of the more expensive electric wheelchair.

The other type of manual wheelchair patient is the one that requires the chair in order to be mobile but is completely unable to control the chair on their own. These patients get the chair so that others can push them around in it to maintain safe control. These patients are typically frail or have no control over their limbs.

Electric Wheelchairs

The electric wheelchair is looked at in the same light as a scooter. However, because of the way it can be controlled, the electric wheelchair is also considered to be easier to use than a scooter. Your doctor will perform a preliminary evaluation to see if you qualify to use an electric scooter. This comprehensive evaluation consists of several categories. You must have the upper body strength to be able to manipulate the controls safely. If you are not have the strength or range of motion needed to operate the electric wheelchair, then you will be putting yourself and others at risk when you attempt to use it.

Qualifying for an Electric Wheelchair

Another consideration for people who want to qualify for an electric wheelchair is their muscle coordination and depth perception. It is sometimes necessary to react quickly when using an electric wheelchair. As you are going through the house, you may need to react to avoid a child or a family pet. The doctor will check your reflexes and your depth perception. Bad depth perception may prevent you from determining how far away something is before you come into contact with it. If you have bad depth perception, the operating an electric wheel chair could mean that you fall down a flight of stairs or injure yourself by colliding with a shelving unit. The doctor must be completely convinced that you will not harm yourself or others before approving you for an electric wheelchair.

Your home will need to be made wheelchair-accessible in order for you to be able to use it. You will need a wheelchair ramp at your front door and any other access doors you may need to use and you will need to find a way to get yourself to the second floor of your home, or move everything to the first floor. You will need to let the supply store know if you want a chair that is for indoor use only, or if you want a chair that can be used outside. You will also need to find a vehicle that you can use to safely transport your chair or transport yourself in the chair if you have an electric wheelchair. There are several considerations when you look into getting a wheelchair.

Does Medicare Cover Wheelchairs?

Your doctor has a comprehensive report that he must complete before Medicare will authorize your wheelchair. The doctor will determine if you qualify for a manual or electric wheelchair, and he will then submit the report to Medicare. Once Medicare approves the doctor's report, you can then order your wheelchair from a participating Medicare provider that accepts assignments.

Will Medicare Pay for my Wheelchair?

Medicare will pay for 80 percent of the costs of your wheelchair after you have paid the Medicare deductible. If you have gap insurance or supplemental Medicare insurance, then you can get the costs of your co-payment taken care of as well and you will not have to pay any costs out of pocket. But there is more to having a wheelchair than just getting Medicare approval.

Medicare Approved Wheelchairs Suppliers

When you search for a wheelchair supplier, be sure to look for a participating Medicare supplier that accepts assignments. A participating supplier that accepts assignments will only charge you the Medicare-approved price. This will help you to keep your co-payment lower. Medicare will help pay for a chair from a participating provider that does not accept assignments, but the costs to you will be higher. Medicare has also instituted a program called "competitive bidding" that will help you get even lower costs on your wheelchair. But it is only available in a limited number of states. Be sure you understand all of the guidelines for getting your wheelchair before you start buying one.