Medicare is a government-funded healthcare program that provides essential coverage to millions of Americans, including those with disabilities or mobility impairments.
For many individuals, mobility scooters can be a lifeline, enabling them to maintain their independence and move around freely.
However, navigating the Medicare coverage options and determining which mobility scooters are covered can be confusing.
In this article, we’ll delve into the topic of Medicare coverage for mobility scooters and provide a comprehensive guide to help you make informed decisions.
We’ll start by outlining the eligibility criteria for Medicare coverage and discussing the different types of mobility scooters available.
We’ll also explore the factors that can impact your Medicare coverage, such as the specific medical conditions that qualify for coverage and the different Medicare plans available.
Additionally, we’ll provide actionable and practical takeaways to help you navigate the complex world of Medicare and mobility scooters, including tips for finding the right mobility scooter for your needs and ways to ensure you’re getting the most out of your Medicare coverage.
By the end of this article, you’ll better understand how Medicare coverage for mobility scooters works, and be equipped to make informed decisions that can help improve your quality of life.
Key Takeaways:
- To get Medicare coverage for mobility scooters, the device must be deemed medically necessary to maintain the quality of life, which includes a doctor’s visit, a physical examination, and a formal prescription of the device by a medical professional.
- Medicare Part B covers mobility scooters, and the maximum coverage allowed is 80% of their cost.
- Medicare will only cover basic models of mobility scooters that cover your medical necessities, and there could be some extra costs if you prefer certain upgrades.
- There are additional costs to consider when owning a mobility scooter, including house modifications, maintenance, and repair costs.
- If Medicare coverage is not granted or is not enough to offset the cost of the device, there are alternatives, such as buying a used one.
Qualifying for Mobility Scooter Coverage
To get coverage for mobility aid through Medicare, or almost any other insurance company, it will be required that it’s deemed medically necessary to maintain your quality of life.
This is a straightforward process, but that takes many steps, and we discuss at length in the following article:
However, to sum it up, it will likely entail the following:
- A visit to your doctor to discuss the best mobility device for you
- A physical examination performed by a medic or physical therapist
- A formal prescription of the device by a medical professional thoroughly explaining why only a scooter (and no other aid such as a cane or wheelchair) would be suitable for you
- A visit to a durable medical equipment provider to start the purchase process
- A home survey to determine whether your house is apt for using a scooter inside
And with regard to that last item, it’s important to know that Medicare will only cover disability scooters intended for indoor use.
If you plan on getting a scooter just for shopping or going to the park, it’s unlikely that the insurer will pay for it.
Additionally, Medicare will only cover mobility scooters that are purchased from Medicare-approved suppliers.
These suppliers must meet specific standards and provide documentation that the scooter meets Medicare’s criteria for coverage.
How Much Does Medicare Cover?
Mobility scooters are included within Medicare Part B among other similar mobility aids, and the maximum coverage allowed is 80% of their cost.
This means that you will still have to pay out-of-pocket for the remaining 20%.
We discuss alternatives for how to pay for that difference in the following article:
What Kinds of Mobility Scooters Will Medicare Pay for?
Medicare will only pay for the most basic models of mobility scooters that cover your medical necessities.
This means that there could be some extra costs if you prefer getting certain upgrades, or if you are looking for more advanced units.
Now, going back to what’s medically necessary, for instance, if you are a bariatric patient, or require a special type of scooter, and your doctor recommends so, it’s likely that a better-equipped scooter might be covered.
However, you should always consult with your doctor and the nearest Medicare-approved mobility aid retailer near you.
Mobility Scooter Models Likely to Be Covered by Medicare
As I mentioned earlier, coverage will depend on a case-by-case basis, however, the following models are likely to be approved:
- Pride Go Go Elite Traveller
- Pride Go Go ES2
- Pride Maxima Power Scooter
- Pride Victory 10
- EWheels M34
- EWheels M35
- Shoprider Dasher
- Golden Buzzaround XLS-HD
- Golden Companion
- Vive Health 3 & 4
- Buzz Around XL
- MiniRider Lite
Although most scooters covered are standard units, there’s usually no preference for 3 or 4-wheel models for getting approval, although, 3-wheel disability scooters are recommended for indoor use due to their tighter turn radius.
You can learn more about the differences between these kinds of scooters here:
Other Costs to Consider
Owning a mobility scooter will bring some extra costs that you should consider.
To start with, after getting approval you will have to pay 20% of the price tag, which can easily ascend to up to $200 to $400.
But after you have your unit, you might have to face certain house modifications such as adding ramps, widening doorways, or setting up proper storage space for your new device.
Another important factor to consider is maintenance and the periodic services any scooter will need to keep functioning properly, we can estimate that at $100 to $200 yearly.
Finally, just like any other vehicle, a disability scooter can break down, and given they are rather specialized medical equipment, repairs are not cheap.
We usually consider an extra $100 yearly, on average, for fixing or replacing parts that might break down.
Alternatives to Medicare Coverage
Sometimes Medicare coverage will not be granted, or it will not be enough to offset the cost of the kind of device you want.
Luckily there are alternatives to get a discounted unit such as buying a used one:
Or breaking the initial cost on monthly installments by financing:
Choosing the Right Scooter for You
Now that you have a clearer idea about what kind of scooters you can expect Medicare to pay for, it’s important that you decide which one will be the best for you.
And although this is something you should discuss at large with your doctor and medical equipment supplier, we have a guide that can get you up to speed with some basic information:
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.
Mallory is an occupational therapist with a passion for helping the elderly maintain their independence and mobility. After working in the field for several years, she decided to start sharing her knowledge and experience with a wider audience. Through this site, Mallory offers practical tips and exercises to help seniors improve their mobility and manage any limitations they may have. She is dedicated to providing accessible and effective resources to help her readers lead happy and healthy lives.