How to Get Medicare to Pay for Wheelchairs

Medicare will pay for any type of wheelchair under specific circumstances, and only with a prescription from your physician. Medicare officials must be convinced of your dire need to have one to retain the independence you have always known. Once they approve, they will pay a percentage of the cost (once you have met the deductible), but will pay in full for maintenance.

Instructions

• 1

  Get a prescription for a wheelchair from your family doctor. Present this prescription to the Wheelchair dealer of your choice. This must clearly state you need the wheelchair to take care of yourself, your home and family. Add the fact that it is the only way you can get around. Medicare may not pay for the wheelchair if it sounds like the wheelchair will make life easier for you. They are not interested in how it can help you--they only want to make sure that without it, you would be totally helpless and prone to accidents.

• 2

  Tell your physician that the only valid reasons Medicare will accept (and approve payment), is if you cannot walk--even if you use some sort of a crutch to lean on. Unless you convince Medicare that if you do not get a wheelchair you will be totally and completely confined to your home and bed, they probably will not approve payment.
  It is equally important that they understand that you will have no problem getting into, sitting in and getting out of the wheelchair as well as using the controls. They need to be convinced that the wheelchair will be used almost completely inside the home to allow you the feeling of independence and the ability to continue to care for family and pets.

• 3

  Make sure that you have added Medicare Part B coverage to your Medicare. Without this, Medicare will not reimburse the purchase or rental of a wheelchair. Reasons and specific needs for buying or renting a wheelchair must be included in your medical records. Proper documentation is important along with specifics about why you need it, how or what happened to cause you to need a wheelchair, and if it is needed temporarily or long term.

• 4

  Buy your wheelchair from a dealer and give the salesperson the physician's prescription. Once you make the purchase, the dealer will fill out the "Certificate of Medical Necessity" form. After he fills out the product information section, he will then give you the form. Take the form to your doctor and have her fill out the rest. The "Certificate of Medical Necessity" is simply a more detailed prescription required by Medicare. The physician's staff will send this form along with the Medicare Claim form to Medicare. You do not submit this yourself. The physician must always sign and date the form as they do not allow any signature or date stamps. For more information, contact [phone] or check the Medicare website.