It can be challenging at any age to get around without help. Some people use a cane or walker, but others may need a knee or electric scooter. The appropriate equipment is essential for decreasing the risk of falling. Medicare will cover some durable medical equipment (DME) under its Part B benefit. But does it include electric scooters? This article reviews Medicare’s coverage of electric scooters and how to obtain one.
Electric scooters are covered under Medicare Part B.
A prescription, face-to-face encounter, and sometimes, a preauthorization is needed.
Specific criteria need to be met to qualify for power scooters and wheelchairs.
Your medical provider and DME supplier will need to be Medicare-approved for coverage to be given.
What scooters does Medicare cover?
Medicare Part B covers power-operated vehicles (scooters), walkers, and manual and electric wheelchairs. Coverage is provided if the equipment is necessary to perform basic activities in the home, such as getting out of bed. Different criteria will need to be met based on the durable medical equipment (DME), and sometimes preauthorization is required.
Depending on the equipment necessary, it may be rented or purchased. You must also prove you can safely operate the DME. Original Medicare does not cover knee scooters, even with a prescription. Walkers and rollators are covered under the DME benefit, but knee scooters (also known as knee walkers) are not considered medically necessary and are therefore not covered by Medicare.
What Medicare parts cover motorized scooters?
Scooters are covered under Medicare Part B and some Medigap and Medicare Advantage (MA) plans. Medicare considers equipment to be DME when it will be used repeatedly, is medically necessary, used in the beneficiary’s home, and is expected to be used for at least three years.
Some Medigap plans cover Part B excess charges, including the cost of DME. Coverage under an MA plan varies from state to state and plan to plan. Coverage is also dependent on the needs of the beneficiary.
Medicare Part B covers DME, such as scooters. Coverage is 80% of the cost after a $226 deductible is met. A prescription is required, and if you are seeking a power wheelchair or scooter, you will need a face-to-face encounter with your medical provider. Medical and DME providers must be enrolled in Medicare for your device to be covered. If your DME provider is Medicare approved, they can only charge the amount approved by Medicare. If they are not approved, you will be responsible for any charges over the Medicare-approved amount.
Because MA plans are purchased from private companies, the coverage for scooters and other DME depends on the plan purchased. The cost may be different than with Original Medicare coverage. Speaking with an insurance broker in your area is the best way to determine what MA plans are available to you with a DME benefit.
Medigap plans F and G (both regular and high-deductible versions) cover 100% of Medicare Part B excess charges. If you have one of these Medigap plans, it’s possible you will not have out-of-pocket expenses for your DME after the Part B deductible is met. Medigap plans only cover what Original Medicare does. There is no separate DME benefit with Medigap plans.
How much will Medicare pay for mobility scooters?
Medicare Part B will cover 80% of the scooter cost after the deductible is met. The cost to the beneficiary depends on the mobility scooter's cost and a Medigap plan that provides additional coverage. Electric scooters will cost more than manual wheelchairs. They also have different criteria to meet for the coverage to be approved.
Are all scooters Medicare approved?
Not all scooters are Medicare approved. Medicare provides coverage for manual wheelchairs and electric (power) scooters, but not knee scooters. certain criteria must be met for an electric scooter or wheelchair to be approved. This is in addition to obtaining a prescription from your medical provider. If you want Medicare to cover your DME, you will need approval from a DME provider. A list of providers can be found on the Medicare website.
How to know if I qualify?
You can visit the Centers for Medicare and Medicaid Services website to see if you're qualified. It details the steps needed to obtain a DME. Different qualifications will need to be met depending on the equipment type.
An electric scooter may be an option if you cannot use a walker, cane, or manual wheelchair safely. You must be able to get in and out of the scooter and sit up to operate the controls.
You may need a power wheelchair if you cannot use a manual wheelchair and don’t qualify for an electric scooter. To obtain a power wheelchair under your Medicare Part B benefit, you will need a prescription, a face-to-face encounter with your medical provider, and preauthorization. With preauthorization, your DME supplier submits information to Medicare specifying the need for the equipment. Medicare reviews the information and sends a decision letter to your DME provider.
Does Medicare cover scooters for seniors?
Medicare covers scooters and wheelchairs under the Part B benefit. They do not cover knee scooters as these are not considered medically necessary. A prescription from your medical provider is needed. Your medical provider and DME supplier must be Medicare approved for coverage.
How much will a mobility scooter cost?
The cost of a mobility scooter will depend on a few factors. The type of scooter is the greatest factor. Medicare Part B covers 80% of the total cost after the deductible is met ($226 in 2023). If your DME provider is approved by Medicare and agrees to the assignment, they can only charge you the Medicare-approved amount.
Which mobility scooter is the best?
The best mobility scooter fits your needs and is safe to use. For manual wheelchairs, you must have enough upper body strength to use them. For power scooters and wheelchairs, you must be strong enough to sit up in the chair and use the controls. Your medical provider can help you decide which scooter is best for you.