Medicare Coverage

FAX: 713-583-9150

MEDICARE

To See If You Qualify, Please Call 1-888-583-1810 Today!!!!

One of the most common questions we are asked by our customers is if Medicare or Private Insurance will cover the cost of an electric wheelchair or scooter.

If you have Medicare insurance and /or private insurance and you qualify through your doctor, you may be able to receive a power wheelchair for little or no money out of pocket !!!!! We will handle all of the paperwork for you and let you know as soon as we have approval from your doctor! Sorry, we do not deal with any HMO insurances. For
to see if you qualify call 1-888-583-1810

Criteria for Electric Wheelchairs

We do accept assignment on electric wheelchairs. This means that if you qualify, we will deliver the power chair to you, and bill Medicare or your private insurance company for payment. Sorry, we do not handle any HMO insurances. To see if you qualify for a power wheelchair, your doctor must complete a form called a Certificate of Medical Necessity (CMN) . We must also collect a prescription from your doctor as well as a Medical Face to Face Evaluation form completed by your doctor or physical therapist. The way that your doctor answers the questions on the CMN will determine if the power wheelchair is a medical necessity. Listed below is what Medicare states as the medical criteria that must be met in order to qualify:

An electric wheelchair is usually covered when all of the following criteria are met:

	The patient's condition is such that without the use of 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 scooter or power wheelchair.

Criteria for Scooters

If you purchase a scooter from us, Medicare and Private insurance may reimburse you if you meet there coverage criteria. We do not accept assignment on scooters. This means that you must purchase the scooter first, then we will contact your doctor for you and request the paperwork needed in order to file a claim with your insurance company for reimbursement to you. We do not guarantee reimbursement from Medicare or any Private Insurance companies. We will file the claim for you with Medicare, or private insurances that are a PPO, if you qualify through your doctor.
Sorry, we do not bill any HMO insurances for reimbursement.
In order to file a claim with Medicare for a scooter, we must get a prescription for an electric scooter, a Certificate of Medical Necessity ( CMN ) and a current Medical Face to Face Evaluation form. All requested paperwork is used by Medicare to determine if the scooter is a
medical necessity.

An electric scooter is usually covered when all of the following criteria is met:

	A POV (electric scooter) is usually covered only if it is ordered by a physician who is in one of the following specialties: Physical Medicine, Orthopedic Surgery, Neurology or Rheumatology
	The patient must be unable to operate a manual wheelchair.
	The patients condition must be such that a POV is required for the patient to get around in his or her residence. A POV that is beneficial only in allowing the patient to perform leisure or recreational activities *will be denied* as not medically necessary.

Criteria for Lift Chairs

Unfortunately, Medicare will not pay the entire cost of a lift chair, however, they will reimburse on the lift motor, if you qualify. You must first purchase the Lift Chair, then all of the necessary paperwork will be gathered for you and your claim will be filed for reimbursement. Any payment from Medicare will be sent to you by Medicare.

In order to file a claim with Medicare for a lift chair, a Certificate of Medical Necessity ( CMN ) is required to be filled out by your doctor and filed with your claim. All of the necessary paperwork will be gathered for you and the claim will be filed for you. In some states it is also necessary to get a letter explaining the medical necessity of the item from your doctor. The CMN is used by Medicare to determine if the Lift Chair is a
medical necessity.

A Lift Chair is usually covered when all of the following criteria is met:

	The patient must have severe arthritis of the hip or knee, or have a neuromuscular condition.
	The seat lift mechanism must be part of the physicians course of treatment and be prescribed to effect improvement, or arrest or retard deterioration in the patients condition.
	The patient must be completely incapable of standing up from a regular armchair or any chair in their home.
	Once standing, the patient must have the ability to ambulate.

Medicare Allowable

Listed below is the current Medicare allowable by state for electric wheelchairs, scooters and lift chairs. If Medicare is your primary insurance and if you qualify though your doctor, Medicare may pay 80 % of the amount listed below for your mobility equipment.