According to the University of California’s Disability Statistics Center, about 6.8 million people rely on mobility scooters to get around their homes. Electric scooters may help give people independence and freedom who might otherwise be left in bed. If you’re looking for a Medicare-approved mobility scooter, first you have to qualify to receive one.
Does Medicare Cover Mobility Scooters?
Medicare Part B (medical insurance) covers motorized scooters as durable medical equipment (DME). In order for Medicare to help pay for a power scooter, you must have limited mobility and meet all of the following conditions:
- Your doctor must submit a written order stating that you have a medical need for a scooter to use at home.
- You have a health condition that causes extreme difficulty moving around your house.
- You can’t engage in daily living activities such as bathing, dressing, getting in or out of bed or a chair, or using the bathroom, even with an assistive device.
- You’re able to safely operate the scooter including getting on and off the device, or you have a caregiver with you at all times to help you use the device safely.
- You can use the equipment in your home (for example, it’s small enough to fit through your doors).
- Both your doctor and the equipment supplier are Medicare-approved.
If Medicare approves the device, you may pay 20 percent of the Medicare-approved amount after you pay your Part B deductible for the year. Medicare may pay the other 80 percent.
Medigap Coverage for Scooters
A Medigap (Medicare Supplement) plan is a type of private insurance policy that can help pay for financial items such as Medicare coinsurance (like the 20 percent you’d pay for a scooter) and copays. In 2019, Medigap plans have 10 different coverage levels and each one is assigned a letter.
Note: Plans that cover the Part B deductible (Plan F and Plan C) are going away in 2020, so if you want coverage for those items, talk to an agent to enroll now. Those plans won’t be available to anyone newly eligible for Medicare after January 1, 2020.
Medicare Advantage Scooter Coverage
Medicare Advantage plans are private insurance policies that can provide coverage for more services than Original Medicare. Even though Medicare Supplement and Medicare Advantage sounds similar, they are actually very different.
Medigap plans help pay for Original Medicare-related fees. Medicare Advantage plans offer coverage for the same services as Original Medicare, but they can also offer additional benefits such as hearing, dental, vision, and fitness classes. You cannot have both a Medicare Supplement and a Medicare Advantage plan, so it’s best to meet with an agent to learn what’s right for you.
A Medicare Advantage plan may offer reduced fees for mobility scooters, however, your exact cost depends on your plan.
How to Get a Medicare-Approved Mobility Scooter
In order to get a prescription for a mobility scooter, you must first have a face-to-face visit with your doctor. Your doctor must document your condition and ability to move around your home. Your documentation needs to say that you can’t use other mobility aids, and a scooter is your only option.
The mobility device supplier must receive the order within 45 days of your in-person evaluation.
How to Find a Medicare-Approved Electric Scooter Supplier
Medicare.gov has a DME directory so you can find a Medicare-approved electric scooter supplier. Click here to get started. Enter your zip code in the search bar. We used our home office’s zip code in Nashville, TN for demonstration purposes. Then click “Go” beside the green arrow.
The next page you reach allows you to select which DME you need. Since you’re looking for a scooter, check “Power Operated Vehicles (Scooters).” Then click “Search.”
Click “Show All Results ” on the next page.
Then you can see a list of local DME suppliers complete with contact information. You may have to call multiple suppliers to find the right one.
Other Types of Mobility Equipment Medicare Covers
If you can’t use a cane or walker, but you have enough upper body strength to use a manual wheelchair, you may qualify for one instead of a powered scooter. You may have to rent a wheelchair first, even if you plan on buying it eventually.
You may qualify for a power wheelchair if you can’t use a manual wheelchair or electric Hoscooter safely. If you aren’t strong enough to operate the scooter, your doctor may recommend a power wheelchair instead.
Does Medicare Cover Stair Lifts?
Stair lifts are a mobility aid many people use to travel up and down stairs in their homes. Medicare considers stair lifts to be home modifications rather than DME, therefore, Original Medicare doesn’t cover them.
However, some Medicare Advantage plans may cover some of the costs of buying and installing a stair lift chair.
Medicare Scooter Fraud and How You Can Help Stop It
Unfortunately, some DME suppliers are dishonest.
Medicare fraud can happen in a variety of ways. For example, in 2018, an equipment supplier found a woman’s Medicare number and claimed they sold her an electric wheelchair. The supplier did not sell the woman anything. In fact, the 85-year-old “refused the hand of a deputy and climbed into the witness chair” according to the Associated Press (AP).
Another example of scooter fraud is suppliers actually giving people scooters who don’t need them. According to the Washington Post, Medicare fraud has been a “top concern in Washington for decades.”
Possible signs of scooter fraud are a supplier offering you a “free” scooter, offering to pay you in cash or to waive your copay, or having a doctor you don’t know order a scooter for you.
If you suspect fraud, call 1-800-MEDICARE (1-800-633-4227) to report the incident. Be sure to write down all of the details of your incident such as the company’s name and who you talked to.
Get Coverage for Medicare-Approved Mobility Scooters
A licensed agent with Medicare Plan Finder may be able to help the best coverage to suit your needs, whether it’s a Medicare Supplement or Medicare Advantage plan.
There may be many plans available in your area, and your agent may be able to find a plan that fits your budget, lifestyle, and one that offers important benefits such as scooter coverage. To set up an appointment, call 833-438-3676 or contact us here today.