Will Medicare Pay for a Mobility Scooter?

When movement becomes a challenge, the impact can extend beyond physical limitations. Mobility allows people to perform daily tasks, connect with loved ones, pursue hobbies, and experience the world. A mobility scooter can be helpful, but the financial aspects of obtaining one can feel overwhelming. This guide offers insight into how Medicare may help cover the cost of a mobility scooter and outlines options for those navigating coverage.

What Is Medicare?

Medicare is a federal health insurance program primarily for individuals age 65 and older, as well as certain younger people with disabilities or specific health conditions. Medicare is divided into several parts, each covering different health care services:

• Medicare Part A: Covers inpatient hospital care, skilled nursing facility care, and hospice care.
• Medicare Part B: Covers outpatient care, home health care, preventative screenings, and durable medical equipment (DME), such as wheelchairs and mobility scooters.
• Medicare Part C (Medicare Advantage): Offered by private insurance companies approved by Medicare. Part C bundles Part A and Part B benefits and often includes prescription drug coverage (Part D).
• Medicare Part D: Covers prescription drugs and certain recommended vaccines.

Understanding Mobility Scooters

You’ve likely seen mobility scooters in everyday life. Theme parks like Disney offer them for guests with mobility needs, and many grocery stores provide electric scooter shopping carts.

Mobility scooters, sometimes called electric conveyance vehicles (ECVs), offer powered mobility to individuals who can’t easily use a manual wheelchair.

Many scooters include a seat, armrests, and simple controls for forward and reverse movement. Mobility scooters may have three or four wheels and often include added features such as storage baskets or USB charging ports.

Does Medicare Cover Mobility Scooters?

Medicare may help cover the cost of a mobility scooter if specific criteria are met. Scooters and wheelchairs are covered when:

• A doctor submits a written order stating medical necessity for use of the scooter in the home.
• The individual has limited mobility, and all the following apply:
  • The individual cannot complete activities of daily living, such as cooking, bathing, or dressing, even with a cane, crutch, or walker.
  • The individual can safely operate the scooter.
  • The individual can safely get on and off the scooter.
  • Both the treating physician and the durable medical equipment supplier accept Medicare.
  • The physician or supplier has confirmed the scooter can be used safely inside the home.

Even with Medicare coverage, out-of-pocket costs are possible. Medicare Part B generally covers 80% of the approved amount after the annual deductible is met. The individual is responsible for the remaining 20%, as well as any additional charges. To minimize costs, confirm that both the treating physician and the DME supplier are Medicare-approved.

How Do I Get a Mobility Scooter Through Medicare?

A standard process must be followed for individuals enrolled in Medicare who are seeking a mobility scooter:

1. Schedule a Doctor Visit: A doctor will assess mobility needs and confirm the individual can safely a mobility scooter. If the individual qualifies, the doctor provides a written order explaining the medical need for a mobility scooter.
2. Check for Prior Authorization: Certain types of mobility scooters require prior authorization. Durable medical equipment suppliers work with physicians to submit the required documentation.
3. Wait for Medicare’s Decision: Medicare reviews the request to verify eligibility. If approved, the equipment supplier delivers the scooter for home use. Individuals and caregivers may contact the supplier or Medicare directly for updates.

Understanding Denials and Appeals

Requests may be denied if Medicare determines the device is not medically necessary or if supporting documentation is insufficient. If denied, the supplier may resubmit the request, or the individual may file an appeal.

What Is the Best Mobility Scooter Brand?

Pride Mobility, Whill, and Paiseec are popular mobility scooter brands. The best scooter depends on individual needs and how the scooter will be used.

Key considerations include:

• Ease of Transport: Those who have a wheelchair accessible vehicle will generally have an easier time transporting a mobility scooter. Some individuals will need to consider whether the scooter can be easily disassembled for transport.
• Weight Capacity: Ensure the scooter supports the user's weight comfortably, including any additional items they may carry.
• Battery Life & Range: Consider how far the scooter can travel on a single charge. Most scooters can travel between 10-12 miles before needing to be charged again.
• Terrain Compatibility: Check wheel size and suspension, and determine where the individual is most likely to use the mobility scooter; indoors, outdoors, or on uneven terrain
• Number of Wheels: The number of wheels on a mobility scooter will determine the turning radius and stability. Three-wheeled models have a smaller turning radius but are slightly less stable. Four-wheeled models have a larger turning radius but offer greater stability.
• Comfort: For those who will use a mobility scooter for prolonged periods of time, consider the comfort and adjustability of seating, and the steering column, also known as the tiller.
• Speed: Most mobility scooters have a maximum speed of about five miles per hour. Finding a comfortable speed for various environments is important to ensure safety.
• Storage & Accessories: Baskets, cup holders, or other accessories are available on some scooters for convenience
• Maintenance & Durability: Consider how easy it is to service the mobility scooter if it needs repairs. Generally, the individual's durable medical equipment (DME) provider can service the scooter, but not all DME providers can service all scooters.

Accessible Vehicles for Scooters

Mobility scooters provide independence, but transporting them can be challenging. A wheelchair accessible van can make a significant difference, especially for individuals and caregivers who travel frequently.

From short-term rentals to long-term solutions, accessible vehicles can reduce physical strain and improve day-to-day mobility. Visit your local BraunAbility dealer to explore options for renting or purchasing a wheelchair accessible van or SUV.