How to Protect Your Power Chair & Scooter Medicare Benefit

Medicare is a federally operated health insurance program created under the Social Security Act of 1965 to provide medical coverage to elderly (age 65 and over) and certain disabled individuals. Original Medicare includes Part A hospitalization and Part B outpatient medical benefits. Part B coverage may pay for 80 percent of the rental cost for a power chair or electric scooter if you meet strict medical requirements, obtain a physician's order and use a Medicare-approved provider. Securing your power chair and scooter benefit under Medicare has become more difficult recently because of fraudulent billing claims submitted by suppliers for power chairs and scooters that were not medically necessary.

Things You'll Need

• Physician's order
• Medicare card
• Medicaid card (optional)

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Instructions

• 1

  Consult your physician about whether you meet the Medicare requirements for renting a power chair or electric scooter. To qualify, you must be unable to walk even with use of other mobility devices (a walker or cane, for example), be unable to use a manual wheelchair because of upper body weakness caused by illness or injury and be able to safely get on and off of the electric scooter or power chair. You must prove that you'd spend most of your waking hours in bed or sitting in a chair because you couldn't move independently--and that a power chair or electric scooter would solve that problem.

• 2

  Request a prescription for an electric scooter or power chair from your physician. Verify that your physician has documented medical necessity in accord with Medicare guidelines.

• 3

  Contact 1-800-Medicare for a list of Medicare participating power chair and electric scooter suppliers. Contact a few of these suppliers to obtain price quotes. Ask whether the coinsurance amount is due up-front or will be billed to you. Raise any other concerns you have. Select the supplier that best suites your needs. If you are already enrolled in Medicaid and have Qualified Medicare Beneficiary (QMB) benefits, skip to Step 5. If not, proceed to Step 4.

• 4

  Contact your state Medicaid office to inquire about your eligibility for Medicaid, including the Qualified Medicare Beneficiary (QMB) program. If you are eligible, complete an application to enroll in Medicaid with QMB, since QMB most likely will pay the 20 percent of the power chair or scooter cost that Medicare will not pay.

• 5

  Provide the supplier with your Medicare card, Medicaid card (if you have Medicaid) and prescription for a power chair or electric scooter. If you do not have QMB or other coverage that is willing to pay the 20 percent of the cost that Medicare does not cover, you may have to pay for this up-front. If you continue to require use of the power chair or electric scooter after nine months of use, proceed to Step 6.

• 6

  Contact the supplier to obtain a "purchase option letter" if you have not received it by the middle of the ninth month of having the power chair or electric scooter. Return this letter within 30 days of receipt, stating whether you would like to continue renting or purchase the electric scooter or power chair.