Social Security

Wheelchair Medicare Coverage:The Process Defined

Medicare can help you purchase a wheelchair in such conditions, wherein you are bed-ridden or chair confined, and that you need a wheelchair to move around and perform your daily chores, but not as a luxury item.

Medicare can help you purchase a wheelchair in such conditions, wherein you are bed-ridden or chair confined, and that you need a wheelchair to move around and perform your daily chores, but not as a luxury item.

To avail the facility, your physician is required to give a Certificate of Medical Necessity (CMN) to be filed with the claim.

he coverage for electric scooters is covered only if they are ordered by a physician who is one of the following specialists: Orthopedic Surgery, and Neurology or Rheumatology. And, all wheelchairs can be ordered by any physician.

Medical Record
In order to substantiate your medical condition, your medical record must contain sufficient papers to be eligible for a wheelchair.

The record should comprise of the diagnosis, the details of the health condition for which the wheelchair is recommended, nature and extent of functional limitations, etc.

A copy of the Certificate of Medical Necessity (CMN) should also be included in the medical records. In case if Medicare asks for more information, then you are required to provide the same for approvals.

The Wheelchair Dealer
The role of the wheelchair dealer or supplier is that they need to cross-check your information for accuracy and authenticity and make sure that Medicare's guidelines and met by your records.

In case the information provided is proved to be fraudulent, then the claim will be denied by Medicare and the supplier/dealer may have to absorb the dollar cost of part or the entire wheelchair. Usually Medicare responds within 30 days of papers submission.

 
Wheelchair Medicare in Home

Medicare pays for a wheelchair when needed for home use only to increase your mobility around the house.

Medicare for Wheelchair payment

Once you have made the choice of your manual wheelchair, most of the time ten monthly rental payments are made by Medicare for the purpose of renting it.

Once you choose to purchase one, Medicare will make three more rental payments (13 total rental payments).

You are responsible for the 20% coinsurance amount and, for unassigned claims, the balance between the Medicare allowed amount and the supplier's charge for the wheelchair. If you select this option, you own the wheelchair and are responsible for the maintenance.

 
Medicare for Renting Wheelchairs

At the time of choosing to continue with renting of wheelchair with the supplier, Medicare makes total of 15 rental payments.

You are responsible for the 20% coinsurance amount unassigned claims, the balance between the Medicare allowed amount and the supplier's charge.

The wheelchair remains yours to use as long as you medically need it; however, the supplier maintains title and ownership of the wheelchair.

 The supplier is also responsible for the maintenance of the wheelchair.

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