Power mobility equipment offers a "new lease on life" to many persons with limited mobility. Medicare reimburses power mobility equipment up to 80% of the Medicare allowable amount if the person qualifies for this benefit and the health care professional certifies that the wheelchair or scooter is medically necessary. Covering all of the Medicare regulations for power mobility equipment could take up volumes. Only mimimal information is included here. Some of this information I learned in training for my position as mobility specialist; other information I have gathered in the past couple of years selling mobility equipment. Current Medicare guidelines for power wheelchairs require that: 1. The person's condition is such that the person would be bed- or chair-confined without the use of a power wheelchair. 2. The person must need the power wheelchair use in the home. Power mobility equipment that is needed only for convenience or for recreational purposes does not qualify for Medicare benefits. Certainly the person may use the power wheelchair to go out; however, if that is the only purpose for the power wheelchair, the equipment would not be an allowable charge. 3. The person cannot propel a manual wheelchair by him- or herself. Weakness or disability of upper extremities (hands, arms, shoulders) must be present. 4. The person must demonstrate ability to safely operate the controls of the power wheelchair. Persons who might injure themselves or others while operating the power wheelchair do not qualify for Medicare reimbursement. Regulations for scooters, or POVs (power-operated vehicles) include the qualifications above; however, the scooter must be prescribed by a specialist in Neurology, Rheumatology (arthritis), Orthopedic Surgeon, or Physiatrist (physical medicine). Scooters require more control of the trunk and the arm strength to operate the tiller. There are a few other guidelines that are useful: 1. Once Medicare had paid for a power wheelchair or POV, they will not pay for a manual wheelchair. If the person has a manual wheelchair that is currently being rented by Medicare, it must be returned to the Durable Medical Equipment (DME) provider. If the chair has been paid by Medicare, the wheelchair is property of the beneficiary. The manual wheelchair need not be returned in that case. If in doubt, contact the Regional Medical Equipent Carrier for your region, or contact the DME company that provided the manual wheelchair. 2. Medicare will not pay for a prosthesis once the person has a power wheelchair. If the person is a recent amputee, the person must be fitted for and receive their prosthetic leg before Medicare will pay for power mobility equipment. 3. With similar rationale, Medicare will not pay for walkers, or canes once they have paid for a power wheelchair. Medicare regulations are always subject to change. Indeed, an organization called RAMP (Restore Access to Mobility Partnership) is currently lobbying for change in the Medicare laws that would ensure that those who need such equipment can get it. For more information on power mobility equipment, check the Medicare web site. Kay Lowe
Mobility Specialist
http://www.health-infosource.com/power_wheelchairs.html |
