If you or a loved one meets the coverage conditions, Medicare will pay for a motorized wheelchair. If your doctor prescribes it and you are approved, then Medicare will pay 80% of the cost of the electric wheelchair. The remaining 20% you are expected to pay. Wheelchairs are pretty expensive and can cost anywhere between $500 to $6000. It is easy to assume that all seniors/disabled people have access to motorized wheelchairs when they need one. But it is a surprising fact that Medicare may not cover the cost of this device like u may have assumed. Read below to know under what conditions Medicare will provide coverage for a motorized/electric wheelchair.

REQUIREMENTS TO QUALIFY FOR MOTORIZED WHEELCHAIR

Under the Durable Medical Equipment (DME) coverage, Medicare Part B covers electric wheelchairs. However, you must meet certain criteria to be approved for it. Following other requirements that you must meet to qualify for a motorized wheelchair through Medicare:

A WRITTEN ORDER FROM YOUR DOCTOR

Your doctor must prescribe a motorized wheelchair for you. He/she must explain in a written form that a worker or cane will not provide the mobility you need and you need the wheelchair for mobility reasons. Medicare only covers an electric wheelchair when they are a necessary recommendation by your doctor. If your doctor is prescribing a motorized wheelchair, you must be unable to use a manual one. The doctor must specify the reason for needing a motorized wheelchair – For example, difficulty getting in and out of bed, dressing up, using the toilet etc. The doctor must also write down if you will be using the motorized wheelchair or you will have assistants from a family member or a caretaker.

A HEALTH CONDITION THAT AFFECTS MOBILITY

If you have a health condition that hinders or restricts your movement then a motorized wheelchair may be for you. If you have trouble walking from one room to the next or getting on or off from a chair or standing for long.

YOU CAN OPERATE A MOTORIZED WHEELCHAIR SAFELY

Medicare will approve a motorized wheelchair if you can safely operate it, or someone else is available to help you. Medicare will not approve the device if you have a condition such as blindness or deteriorating mental capacity which makes it unsafe to use a motorized wheelchair publicly or privately.

YOU CAN USE THE MOTORIZED WHEELCHAIR AT HOME

If you live in an apartment or home where you cannot use the motorized wheelchair Medicare will not approve it. To qualify for a motorized wheelchair your home must be remodeled to accommodate it by making it through narrow doors or stairs. If you are unable to use it in your home, Medicare will not provide coverage.

YOUR DOCTOR IS MEDICARE-ENROLLED

The doctor who treats you for your condition that makes you immobile and your supplier; both must be enrolled in Medicare. You have to use a specific supplier, in some states, for Medicare to pay for a motorized wheelchair. The suppliers you can use can be checked on Medicare’s list of approved suppliers.

WHERE TO GET YOUR WHEELCHAIR?

You can get a motorized wheelchair if you have traditional Medicare from a Medicare contract supplier. To find out where to go for a wheelchair call Medicare at 1-800-633-4227. Or you can visit their official website at gov.

If you are enrolled in a private Medicare plan or Medicare HMO, you should call the plan and follow their rules.

It is important to note that if you do not need a motorized wheelchair for use in your home, even if you need it to go outside, Medicare will not cover it. On the other hand, if you need to use it inside your home, you are permitted to use it outdoors as well.

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