Will Medicare Pay for Wheelchairs?

Danny Fowler of Miami, Florida found the overspending recently when he had to substitute a wheelchair for his wife. He wanted to buy one because he suffers from a kind of muscular dystrophy and necessitates the permanent use of a wheelchair. Medicare only covers the cost of renting one for as much as 13 months. Two months to Fowler’s rental, he learned exactly how far Medicare was paying. The total cost in the class of the rental would top $800. In terms of the costs, your government is well aware that Medicare often pays way too much. The Medicare reimbursement speed for wheelchairs ranges from $490 to $1,750 for your 13-month rental period, depending upon the type of chair.

An online search shows those deals are at least two the retail cost and in many cases more. A light-weight wheelchair like the one Fowler purchased can be obtained because of as little as $99 – eight times less than Medicare’s speed. Medicare does not always receive the best deals because of some of your equipment it buys an official from the Medicare department said. We certainly recognize that many of these deals will need to be brought in line with the marketplace. For over 20 years, Medicare has utilized a fee schedule set by Congress to determine reimbursement rates because of wheelchairs together with other medical equipment.

The fees are based on the average amount that equipment suppliers charged Medicare. Whilst the expenses are adjusted for inflation, the changes have not kept pace with technology advances or cheaper production costs that affordable prices. With time, there is a gap that grows. Medicare can’t quantify how much it’s overpaid, but the potential is enormous. In the year 2009 alone, Medicare spent $188 million on manual wheelchairs and more than $8 billion on other durable medical equipment,’ including hospital beds, walkers, and oxygen tanks.

According to Medicare.gov, Medicare Part B (Medical Insurance) covers power-operated vehicles (scooters) and manual wheelchairs as durable medical equipment (DME) that your doctor prescribes for use in your home. You must have a face-to-face examination and a written prescription from a doctor or other treating provider before Medicare helps pay for a power wheelchair. Power wheelchairs are covered only when they’re medically necessary.

Who’s eligible?

All people with Part B are covered.

Your costs in Original Medicare

If your supplier accepts assignment, you pay 20% of the Medicare-approved amount, and the Part B deductible applies. Medicare pays for different kinds of DME in different ways. Depending on the type of equipment:

 

  • You may need to rent the equipment.
  • You may need to buy the equipment.
  • You may be able to choose whether to rent or buy the equipment.

Medicare will only cover your DME if your doctors and DME suppliers are enrolled in Medicare. Doctors and suppliers have to meet strict standards to enroll and stay enrolled in Medicare. If your doctors or suppliers aren’t enrolled, Medicare won’t pay the claims submitted by them.

It’s also important to ask your suppliers if they participate in Medicare before you get DME. If suppliers are participating suppliers, they must accept an assignment. If suppliers are enrolled in Medicare but aren’t “participating,” they may choose not to accept an assignment. If suppliers don’t accept assignment, there’s no limit on the amount they can charge you.

To read the whole article from Medicare.gov, visit: https://www.medicare.gov/coverage/manual-wheelchairs-and-power-mobility-devices.html and get more information.

 

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