Does BCBS Insurance Cover Mobility Scooters?

Mobility scooters can be an essential tool for enhancing the independence and quality of life of individuals who have difficulty with mobility due to age, illness, or disability. 

They enable users to perform daily activities with ease, maintain an active lifestyle, and participate fully in their community. 

Despite the numerous advantages they offer, mobility scooters can be quite an investment, with costs ranging from hundreds to several thousand dollars. 

This significant outlay can be a barrier to many who would greatly benefit from these devices. 

Therefore, it’s not uncommon to wonder if health insurance companies, like Blue Cross Blue Shield (BCBS), provide coverage for mobility scooters.

This article will explore the extent of coverage that BCBS provides for mobility scooters and guide you through the process of securing coverage, including qualifying criteria, types of scooters covered, and potential out-of-pocket costs. 

Additionally, we’ll look at alternatives if BCBS doesn’t approve your mobility scooter. 

Let’s embark on this journey of information discovery together.

Key Takeaways

• BCBS Insurance Does Cover Mobility Scooters: BCBS does provide coverage for mobility scooters, but coverage can vary widely between different BCBS policies and geographic locations. It is essential to contact your local BCBS provider to find out the exact details of your policy.
• Qualifying for a Mobility Scooter: Qualification for a mobility scooter under BCBS usually requires a doctor’s prescription indicating that the mobility scooter is medically necessary. The person must be unable to move around without assistance due to a health condition or disability.
• Process for Getting Coverage: After getting a doctor’s prescription, you will need to submit a Prior Authorization request to BCBS. This request must include the prescription and any additional supporting medical documents. BCBS will then review the request and decide if they will provide coverage.
• Does BCBS Cover the Full Price of a Scooter?: BCBS typically does not cover the full cost of a mobility scooter. They usually pay a portion of the cost, and you are responsible for the remaining amount. This remaining amount can be paid out-of-pocket or through supplemental insurance if available.
• Kinds of Mobility Scooters Covered: BCBS generally covers standard models of mobility scooters. If you require a more specialized model due to your specific needs, you may have to cover the difference in cost.

BCBS Insurance Does Cover Mobility Scooters

The good news is that yes, BCBS does typically provide coverage for mobility scooters. 

However, it’s important to note that the exact coverage can vary significantly between different BCBS policies and geographic locations. 

BCBS is comprised of 36 separate health insurance organizations, each offering various plans and benefits depending on the state and the specific group. 

This means that what is covered under one BCBS policy may not be covered under another.

Therefore, it is crucial to reach out to your local BCBS provider to understand the specifics of your policy. 

You can typically find their contact information on your insurance card or by visiting the BCBS website. 

In addition, the Insurance Guide to Mobility Scooters provides a broad overview of the ins and outs of mobility scooter insurance, which can serve as a useful starting point for your research.

Moreover, it’s also worth noting that while BCBS may provide coverage for mobility scooters, they will not do so unless the device is considered medically necessary. 

This is a standard requirement among most health insurance providers, not just BCBS. 

Therefore, the next section will delve into what it means for a mobility scooter to be medically necessary and how you can qualify for one.

Qualifying for a Mobility Scooter

When it comes to whether you’re eligible for a mobility scooter, Blue Cross Blue Shield (BCBS) follows guidelines similar to Medicare. These guidelines dictate that an individual must have a medical need for a mobility scooter. This need typically stems from a condition that affects mobility, such as arthritis, lung disease, or a heart condition.

For instance, you may be eligible for a mobility scooter if you can’t perform daily activities without assistance. Activities can include getting around your home, doing chores, or attending to personal hygiene. Furthermore, your mobility issue shouldn’t be solvable with the use of a cane, walker, or manual wheelchair. You can find more on this topic in the article about getting a prescription for a mobility scooter.

Lastly, your doctor must validate your need for a scooter in a written prescription. It should include your specific medical condition, why a less expensive device won’t meet your needs, and why the scooter is necessary for daily movement.

Process for Getting Coverage

To begin the process of getting coverage for your mobility scooter, you’ll need to consult with a healthcare provider who is part of the BCBS network. It’s essential that this provider understands BCBS’s specific requirements and that they document your need for a mobility scooter accurately.

Next, the provider will need to submit a Prior Authorization request to BCBS. This is a preliminary step before BCBS will consider covering your mobility scooter. It includes a review of your medical history, current health condition, and the provider’s documented reason for the need for the mobility scooter. Learn more about this process in this financing your mobility scooter guide.

Once the Prior Authorization is approved, you can select a mobility scooter from a BCBS-approved provider. It’s important to note that BCBS may not cover all types of scooters, so ensure the one you choose is included in BCBS’s approved list.

Does BCBS Cover the Full Price of a Scooter?

BCBS does provide coverage for mobility scooters. However, it’s unlikely that BCBS will cover the full price. BCBS’s coverage is based on what it considers “medically necessary.” As such, any extras or upgrades, such as increased speed or enhanced comfort features, may not be covered. Therefore, you may still need to pay a portion of the cost out-of-pocket.

Keep in mind that each BCBS policy can differ in terms of coverage. It’s crucial to contact BCBS directly or consult with your healthcare provider to understand what will be covered under your specific plan.

Kinds of Mobility Scooters Covered

BCBS will likely cover the cost of a basic mobility scooter that meets your medical needs. However, BCBS might not cover certain types of scooters, such as those designed purely for outdoor use, as they might not be deemed medically necessary. Therefore, it’s best to focus on types of mobility scooters that are more geared towards improving mobility for daily tasks and activities.

For more specific information on what models are covered, consult your plan’s policy documents or contact BCBS directly.

Out-of-Pocket Costs After Insurance Approval

Even with insurance approval, there may be out-of-pocket costs associated with obtaining your mobility scooter. These costs can come in the form of deductibles, co-pays, or coinsurance. Essentially, these are portions of the healthcare costs that your insurance plan doesn’t cover.

Furthermore, as mentioned earlier, any upgrades or extras to the mobility scooter may not be covered by BCBS and would need to be paid for out-of-pocket. It’s important to factor these costs into your budget when considering a mobility scooter. You might find this mobility scooter buying guide useful to understand all the possible costs involved.

Alternatives if BCBS Doesn’t Approve Your Scooter

If BCBS does not approve your mobility scooter, don’t fret. There are alternative solutions available to you. First, you could consider purchasing a used mobility scooter. These can often be found at a fraction of the cost of new models. Here’s a guide to buying a used mobility scooter that can help you navigate the process.

You could also explore programs that offer free or low-cost mobility scooters to those in need. Several non-profit organizations and charities offer such programs, and you can learn more about these in this article about free mobility scooters.

Lastly, renting a mobility scooter is another viable option. This could be a more affordable choice if you only need the scooter for a short period. Check out this resource about renting a mobility scooter for more information.

In conclusion, while BCBS insurance does provide coverage for mobility scooters, it’s essential to fully understand the process and potential out-of-pocket costs. 

Additionally, if your insurance doesn’t approve your scooter, several alternatives can help ensure you gain the mobility support you need.

All the claims made in this article are only for informational purposes, based on the writer’s experience and not clinical advice. You should always consult your physician or physical therapist if you have any doubts about how this applies to your specific case.