Medicare and Electric Wheelchairs
Medicare is used by over 40 million Americans as their source of health insurance. Instituted in the 1960’s, it provides a valuable service to those who are disabled or over 65 years of age. One of the major advantages of Medicare is that it covers durable home Medical equipment.
With Medicare, almost any piece of equipment that can be reused is classified as durable medical equipment. This includes things like hospital beds, oxygen equipment, and power chairs. In order for the power chair to be covered, it is necessary to have a prescription from a doctor that states that the power chair is necessary. The chair must be necessary for movement around the home, and if it is only needed for outdoor use then it will not be covered.
Those who have Part B Medicare benefits are eligible to have many of their home medical equipment purchases covered. In the past few years a law was passed that allows people to use private insurance companies in place of Medicare, but these insurance companies must cover the same things that Medicare does. These types of plans are called Medicare Advantage Plus plans.
Those who have Medicare Part B benefits are usually only responsible for 20% of the cost of the chair. The amount covered by a Medicare Advantage Plus plan varies depending on the company holding it. While the private insurance company must cover everything that Medicare does, they can choose how they cover it. This may mean that the power chair costs more to you, but hospital visits cost less. This is one reason that it is very important to carefully choose your Medicare Advantage Plus plan.
With Medicare Part B benefits it is possible to buy the chair, and then submit all necessary paperwork for reimbursement. Medicare will also generally cover some repairs of these units, usually with the same 20% co-pay required from the insured.
Medicare provides a great service for those who need to purchase home medical equipment and many would not be able to afford it without Medicare.
2 Comments so far
Leave a reply
“Medicare provides a great service for those who need to purchase home medical equipment and many would not be able to afford it without Medicare.”
Does the program work the same when a Medicare Beneficiary has a Part C or Medicare Advantage plan (i.e. Secure Horizons).
I know from the plan details that many of these Medicare Advantage plans still only pay 80% and leave their member with 20% of the bill.
Can they still get a scooter with these plans? Is it more or less difficult?
Thanks for commenting Mike.
Generally the amount that any privately run Medicare Advantage Plan covers for Durable Medical Equipment, will vary. Some companies are better than others.
After a little research, it appears that the company you listed, Secure Horizons, usually requires 30% of the cost of Durable Medical Equipment, such as wheelchairs or scooters.
This is more than traditional Medicare and helps to make the point of how important doing your research is before you sign-up for a plan. Plans such as the one you asked about, might offer a better deal on doctors visits or save the insured money elsewhere, but to do so, they raise the cost of other services, like durable medical equipment.
Sometimes it is also more difficult to get reimbursement for these types of devices. For instance using the company you listed, it appears that some people have had trouble getting reimbursed for durable medical equipment, so this plan might not be the best choice for those that will need their wheelchairs and scooters covered.
When choosing a Medicare Advantage Plan, always fully read the details of the plans and the costs of different services. Compare these to the cost of traditional Medicare. Often you will find that the plans aren’t really all that great of a deal.