Mobility Scooters and Medicare: What Will Be Covered?

Mobility Scooters and Medicare What Will Be Covered

Do you need help getting around due to illness or injury? Are you worried about paying for a walker, crutches, complex rehab wheelchair, or mobility scooters? You are not alone.

Worldwide, about 650 million people have disabilities. About 10% or 65 million of these people need a wheelchair.

Before making a purchase, it is wise to learn about durable medical equipment and what Medicare covers.

Definition of Durable Medical Equipment

Durable medical equipment, or DME, describes specific medical supplies needed by an individual. You must meet several requirements to get medical equipment that qualifies as DME.

Your healthcare provider must prescribe the supply or equipment for daily use. You also must use this DME at home.

The next question becomes, “Will my insurance help pay for it?” Most insurance providers cover DME such as oxygen, wheelchairs, crutches, or diabetic test strips. You can visit websites or talk to your insurance provider to determine what DME they cover.

Do You Qualify for Medicare?

Many individuals aren’t sure if they can get Medicare. You must meet at least one of the qualifications.

Age. You must be 65 years or older and you:

  • Must be a U.S. citizen or permanent legal resident living in the U.S. for the previous 5 years or more
  • Or your spouse earned 40 credits by working at least 10 years making you eligible for Social Security or railroad retirement benefits
  • Or your spouse works for, or has retired from, government employment and paid Medicare payroll taxes while working

Social Security Disability Benefits: You must qualify for these benefits for at least 24 months. This does not have to be 24 consecutive months.

Railroad Retirement Board: You must qualify for a disability pension from this board and meet certain criteria.

Lou Gehrig’s Disease: If you have Amyotrophic Lateral Sclerosis you qualify immediately.

Kidney Failure: Individuals under the age of 65 who have permanent kidney failure can qualify. You must require dialysis or a transplant.

You or your spouse must also have paid Social Security taxes for a set amount of time depending on your age.

Medicare coverage for DME

Individuals with Medicare Part B have coverage for certain medically necessary DME. You must have a prescription for the DME, and the DME request must meet the following Medicare requirements:

  • It’s durable, meaning that you or someone else can reuse it
  • It’s only used for medical purposes
  • It can’t provide a benefit when you aren’t sick or injured
  • It’s used at home

The final qualifier about home use requires close examination. When hospitalized or in a nursing home paid for by Medicare, this isn’t considered a home setting.

Yet, a long-term care facility does meet the qualification as your home. When you are in a skilled nursing facility that provides your DME, that facility bears responsibility for the DME.

Common examples of DME covered by Medicare include, but aren’t limited to:

  • Hospital beds
  • Infusion supplies
  • Oxygen equipment
  • Patient lifts
  • Wheelchairs
  • Blood sugar monitors

To find out if Medicare will cover your DME, call 1-800-MEDICARE (1-800-633-4227. TTY users may call 1-877-486-2048. You may speak with a service representative 24 hours a day, seven days a week.

It’s important to note that Medicare only covers DME if the prescribing physician and the equipment supplier are enrolled in Medicare.

What is a Mobility Scooter?

A mobility scooter is a wheelchair device designed like a motor-scooter. It may be battery operated and/or electric and requires a key for the ignition. It has a seat with a back and either three, four or five wheels.

There is a flat area for your feet and handlebars to turn the wheels. The scooter requires steering but is easier than pushing a manual wheelchair. You must sit upright and have enough upper-body strength and mobility.

Some mobility scooters can travel over 30 miles. Others have a 10 to 15-mile limit. You manage the speed by applying a releasing pressure on the forward and reverse lever.

Mobility scooters come equipped with regenerative brakes. This type of brake allows you to park the scooter on a slope and not roll away. Some models have an emergency bicycle-style brake.

You manage the speed using the speed dial located on the control panel. Some mobility scooters are street legal.

These often have a switch to adjust the maximum speed from 8 mph to 4 mph. This allows legal driving on pavement.

Class 3 scooters may legally travel at 8 mph on the highway. These scooters must have full lights and indicators. Scooters come in a variety of sizes and styles with different features.

How Can Mobility Scooters Help?

Mobility scooters are often smaller than traditional wheelchairs. They provide increased mobility for people worldwide. Swivel seats make moving on and off the scooter easier.

Individuals with whole-body disabling conditions often lack the upper body strength to use a manual wheelchair. Some examples include coronary or lung problems, various types of arthritis, obesity, and more. These individuals can often stand and walk a few steps and can control the steering tiller.

Some people use their mobility scooter to replace a car. This allows them to travel short distances and participate in activities of daily living.

A disadvantage of the mobility scooter is the longer length. This makes it harder to turn in tight spaces. It also won’t fit on wheelchair lifts for vans or buses.

Questions to Ask When Considering a Mobility Scooter

When thinking about getting a mobility scooter, you need to consider several factors.

What is the mobility scooter’s weight limit?

Most scooters have a maximum weight limit of 250 to 300 pounds. Remember that if you are planning to carry other items, like groceries, this adds weight. You must consider the potential total weight you need to carry.

If you exceed the scooter’s weight limit, this could present a danger to you. Going uphill or over uneven surfaces could result in accidents.

Hand and Finger Strength and Dexterity

If you have a nervous system disorder, a scooter might not help. Examples of disorders can include Multiple Sclerosis or Parkinson’s Disease.

Decreased strength and dexterity in your hands and fingers can make it difficult to control the scooter. This could cause a dangerous outcome.

Some mobility scooter designs compensate for these dexterity limitations. They may use push buttons, joysticks, or brake handles that you squeeze. If you have this type of limitation, it is best to test the scooter options first.

Do You Want to Travel or Transport Items with Your Mobility Scooter?

Most mobility scooter models work in and around the home. Some models allow you to disassemble them for travel. This provides a way to bypass the length issue that prevents their use with wheelchair lifts.

These portable models can go in the trunk and in carry-on baggage for plane travel. Be sure to remove side mirrors and spare parts. Place these items and tools needed for assembly in a carry-on bag if allowed.

Do You Plan to Drive Outdoors with your Mobility Scooter?

If you plan to venture outdoors, look for a mobility scooter designed for this purpose. Getting outdoors provides an improved quality of life and increases longevity. So, take control and hit the road.

Look for a scooter with longer battery life. Finding one with enhanced maneuverability and appropriate tires allows you to safely travel on grass, dirt, sand, and more.

Do You Need Durable Medical Supplies?

Many illnesses are disease processes require temporary or permanent use of medical supplies. Our company provides many durable medical supplies including power wheelchairs. This can help you and those you love to feel secure and offers peace of mind.

Mobility scooters increase independence. This gives a person the confidence to get out and participate in life’s activities. Contact us today to answer your questions about getting medical supplies.