Using a scooter can open a world of possibilities.
You may be finding it increasingly hard to get around. Or you may only need assistance for a specific time, such as following a surgery or injury. Scooters can help you recover and reduce the risk of re-injury.
It can provide you with more freedom and independence. It can allow you to engage in activities you may have previously struggled to participate in. Whether taking a stroll, visiting local markets, or attending social gatherings, a scooter can help you navigate your surroundings confidently.
However, the average mobility scooter ranges from $1,099 to $3,900. Given the considerable expense, you may wonder if Medicare will help you with some of the cost.
In this article, we will discuss what Medicare covers and how to make sure you are eligible for this coverage.
Will Medicare cover my scooter?
Yes. If you are eligible and have prior written authorization, Original Medicare provides coverage for scooters, motorized wheelchairs, and other mobility devices.
What part of Medicare covers my scooter?
Medicare’s coverage for wheelchairs and scooters falls under Part B.
Medicare Part B covers durable medical equipment (DME) that helps individuals with a health condition or illness. DME includes wheelchairs, walkers, hospital beds, and mobility scooters. To qualify for coverage, your scooter must meet specific criteria set by Medicare, which we will discuss below.
Your Medicare Advantage plan may offer additional coverage for scooters beyond what Medicare Part B provides. You will need to look at your Medicare Advantage plan to understand what coverage you have for scooters and other DME.
Medigap (or a Medicare Supplement plan) will also cover your co-insurance cost that Original Medicare does not cover.
Am I eligible to have my scooter covered by Medicare?
There are specific criteria that you must meet before Medicare will cover the cost of your scooter. First, you must make sure that both your physician and supplier are Medicare-approved. Medicare will deny your request if your doctors or suppliers are not enrolled in Medicare.
Some equipment requires prior authorization. You can find the list of mobility devices that require prior approval here. If your prior authorization request has been approved, Medicare will inform your supplier through a letter.
Your doctor will need to prepare and submit a written order stating that:
- You had a face-to-face examination with the doctor
- You have a medical condition that makes it medically necessary for you to have a scooter
- You can safely use the scooter within your home.
You must also:
- Have limited mobility and be unable to perform daily activities
- Have the upper body strength to get on and off the scooter safely
- Be unable to safely move around in your home, even with the help of a cane, manual wheelchair, or walker
How much will Medicare cover?
Once you have paid your annual Part B deductible ($226 in 2023), Medicare pays 80% of the cost of your scooter. You will be responsible for the remaining 20% co-insurance.
Your Medigap or Medicare Advantage plan can help you cover the remaining cost.
Where can I get my scooter?
It’s not quite as simple as picking up a scooter from Amazon. You must purchase your scooter from an accredited and approved durable medical equipment provider in your area. If you have a Medicare Advantage Plan, make sure that you are purchasing from a supplier that your provider approves.
Other Points to Consider
Renting vs. Buying
Depending on your circumstances, you might not need to purchase a mobility scooter outright. If your need for a scooter is temporary or short-term, renting one may be a more practical and economical option. Medicare Part B covers the rental of durable medical equipment (DME) like mobility scooters if deemed medically necessary. This means you could have access to a mobility scooter for the duration of your need without the full cost of purchasing one. Discuss this option with your healthcare provider to determine if it’s the right choice for your situation.
Repairs and Maintenance
An important aspect of owning or renting a mobility scooter is ensuring it remains in good working order. Medicare Part B extends its coverage to include repairs to your scooter, provided a Medicare-approved supplier carries out the repair services. This means that you can save significantly on potential out-of-pocket costs associated with maintaining your mobility scooter over time. Keep this in mind when considering the long-term costs of a mobility scooter.
Coverage for Scooter Accessories
Beyond the scooter itself, you may find that certain accessories or additional components are necessary for your mobility needs. For example, you might need specialized batteries, or a scooter lift for your vehicle to transport the scooter. Medicare Part B may cover some of these necessary accessories. It’s always wise to check with Medicare or a trusted health insurance professional to understand exactly what additional components or accessories might be covered under your plan, ensuring you maximize your benefits and reduce unnecessary costs.
Make your Medicare Journey a Smooth Ride
The Medicare Family is a valuable resource for navigating the world of durable mobility equipment, including scooters. We guide individuals through understanding Medicare coverage for scooters and help ensure they meet the necessary criteria.
We want you to be able to apply for Medicare, choose your plan, and more with confidence and peace of mind. The Medicare Family is here every step of the way, providing personalized guidance to help you make informed decisions. Our team of experts can help you understand what plans are available. We can help you select a plan that aligns with your lifestyle and specific healthcare needs. Get in touch with our team today to learn more about how you can make your Medicare journey a smooth ride.