About Power Chairs Covered by Medicare

Thousands of disabled Americans rely upon power chairs and mobility scooters when they are unable to walk with ease. Medicare, created in 1965 to supplement the Social Security program, provides health care to seniors and other qualified recipients. While a power chair may be of benefit to a patient, Medicare will not pay for it unless the patient qualifies as determined by a licensed physician approved by the Medicare program.

Benefits

• Patients with disabilities and medical conditions that prevent them from carrying out important daily tasks find power chairs invaluable. The use of a power chair increases autonomy and the individual becomes less dependent upon others to transport him from one place to another. Power chairs are beneficial not only for physical mobility; they often bolster self-esteem as the patient takes more responsibility in his environment.

Function

• Medicare pays up to 80 percent of the cost of a power chair for qualified Medicare recipients. Once a patient meets the criteria, She must determine how to fund the remaining 20 percent of the cost. A supplemental insurance program may pay the remainder, depending upon individual coverage limits. Some power chair manufacturers will waive the additional 20 percent if the patient does not have supplemental insurance and is unable to pay.

Considerations

• To qualify under Medicare criteria, the patient must demonstrate a need for the use of a power chair inside the home. Specifically, the patient must not currently be able to provide for his own food and hygiene needs due to his lack of mobility. A Medicare qualified physician must fill out the request form for the patient and send it in to Medicare.

Identification

• The physician who submits the request to Medicare for a power chair will identify the need of the individual by performing a thorough physical exam and determining the extent of the disability. He will also ask questions pertaining to the ability of the patient to care for herself without a mobility device. A person who depends upon a walker or a cane may not qualify if she is still able to perform common daily tasks. Medicare does not consider the intended use of a power chair outdoors to be a qualifying factor.

Potential

• Medicare officials recognize that by increasing mobility, they may prolong admission into a nursing home situation. Although the typical power chairs costs thousands of dollars, it is less expensive than the costs to Medicare when a qualified recipient enters a nursing home. If the patient meets the disability requirements, Medicare will supply a new power chair every 5 years.