Criteria for Electric Wheelchairs Medicare
Medicare for an electric wheelchair is usually covered when all of the following criteria are met:
- The patient’s condition is such that without the use a wheelchair the patient would be bed or chair confined, and
- The patient’s condition is such that a wheelchair is medically necessary and the patient is unable to operate a wheelchair manually, and
- The patient is capable of safely operating the controls for the power wheelchair.
Because part of Medicare criteria is that the patient be unable to operate a manual wheelchair, if Medicare has previously covered the rental of a manual wheelchair, the manual wheelchair must be returned to the company that supplied it before Medicare will cover the cost of an electric wheelchair.
Preapproval of Medicare for Electric Wheelchairs
If you are hoping on the fact that you will be reimbursed by Medicare, but you want a little extra assurance before you purchase the scooter or electric wheelchair, you can file for pre-approval form Medicare. However, Medicare States that “if the review personnel make an “authorized” decision, this does not guarantee payment by Medicare for the product. An “authorized” determination is confirmation that the patients condition as described meets the criteria defined in the DMERC medical policies for the specified item.”
The check for the reimbursement or any and all correspondence from Medicare will be sent to your residence by Medicare. The purchase of a manual wheelchair or a wheelchair or scooter lift is not covered by Medicare at this time. The amount that Medicare allows on durable medical equipment changes from time to time.
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