How to Get a Mobility Scooter Covered by Medicare

Please note that Parentgiving does not accept Medicare. This article explains how, if you qualify for Medicare Part B, Medicare can help pay for the cost of a scooter.

Let’s face it — the older we get, the harder it becomes to move around. If you’re a senior or a caregiver and you or a loved one suffers from mobility issues, you may qualify for a scooter with Medicare Type B if you meet the right requirements.

Understanding Medicare Part B Coverage (Medical Insurance)

For those who are 65 years and older and are a U.S. citizen or permanent resident for at least five consecutive years, you may qualify for Medicare Part B, which covers medical services and supplies necessary to treat your medical condition. This includes durable medical equipment (DME) such as power-operated scooters and manual wheelchairs. According to medicare.gov you’re automatically eligible for a motorized scooter if you’re covered by part B.

Keep these facts in mind as you take steps to acquire a mobility scooter:

• Mobility scooters are only covered by your medical insurance when medically necessary.

• Before Medicare considers paying for your scooter, you must have a face-to-face appointment and a written prescription from a doctor.

Eligibility Criteria for Medicare to Cover a Mobility Scooter 

In order to receive a mobility scooter that’s covered by insurance, you need to have a written order from your doctor stating you have a medical need for a wheelchair, have mobility issues, and meet certain physical medical and physical limitations. 

What Counts as “Medically Necessary” 

Here are the qualifiers that would make you a candidate for receiving a Medicare-assisted scooter: 

• The inability to perform daily living activities (bathing, dressing, getting in and out of bed or a chair, using the bathroom without a cane, walker, or crutches). 

• Having a health condition that causes significant difficulty moving around in your home. 

Medicare’s Functional Limitation Criteria 

Medicare requires that you have functional limitations in order to qualify for your scooter:

• Medicare requires that you, as stated above, cannot move about your home without a walker, cane, or crutches in order to get a scooter. 

• Both your doctor and the durable medical equipment (DME) supplier need to accept Medicare. 

• Your doctor or DME supplier is required to visit your home and verify that you can use the equipment within your home.

• You’re able to safely operate and get on and off a wheelchair or scooter, or you have someone who can help you. 

Step-by-Step Guide to Applying for Scooter Coverage

Remember, applying to get a scooter is considered a piece of DME, so it must go through a process of approval. 

Step 1: Consult a Medicare-Participating Doctor

First, contact your healthcare provider and make sure they take Medicare. Explain your mobility issues and, after an assessment, they will determine if you qualify for a scooter. 

Step 2: Obtain a Prescription and Medical Documentation 

If your doctor deems you an appropriate candidate for a scooter, they’ll provide a written prescription for one. This must be shown to receive coverage from Medicare. 

Step 3: Find a Medicare-Approved DME Supplier

To find a Medicare-approved DME supplier, you can: 

• Use Medicare’s website (medicare.gov) and use the online tool, “Find a Doctor or Other Healthcare Provider.” Input your zip code, the type of equipment you’ll need, and it will provide Medicare-suppliers in your area. 

• You can also contact Medicare directly, as they can provide you with a list of suppliers in your area.

• Ask your doctor. Once you are prescribed a scooter, your doctor can give you a list of DME suppliers in your area.

Participating suppliers will agree to accept Medicare's approved amount as full payment. This means you’ll pay less out of pocket, and they will handle filing the claim directly with Medicare for you. On the other hand, non-participating suppliers can charge more than Medicare’s approved amount. This means you’ll pay more out of pocket, and you’ll also need to file the claim yourself with Medicare to get reimbursed.

Step 4: Submit Your Claim to Medicare

For doctors and suppliers that take Medicare, they will file the claim for you. In rare circumstances, you may need to file the claim yourself. The timeline of processing claims may vary, but it typically takes Medicare 30-60 days to reach a decision, depending on the complexity of the claim, the time of year, and whether there is any missing information. 

Purchasing a Scooter if You Don’t Qualify for Medical Coverage

If you don’t meet the requirements to qualify for Medicare Part B and you need to pay out of pocket, you can still purchase a mobility scooter conveniently online. Sites, such as Parentgiving, offer a massive selection of mobility scooters at reasonable prices. Electric mobility scooters are available in three types: 

• Travel mobility scooters 

• 3-wheel scooters

• 4-heel mobility scooters

On the other hand, if you do qualify for Part B, you need to purchase a scooter from a qualified DME supplier that accepts the assignment cost from the federal government. 

Costs for a Mobility Scooter Under Medicare

If your DME provider is willing to work with your insurance and accept the assignment costs, you’ll have to pay 20% of the amount approved by Medicare. Scooters typically range from $750-2,000 and the Part B deductible will apply to the remaining amount.

Depending on where you live, you may be subject to Medicare’s Competitive Bidding Program. Medicare’s durable equipment, prosthetics, orthotics, and supplies (DMEPOS) competitive bidding program can change the amount Medicare would typically pay for a scooter.

According to Medicare.gov, “suppliers submit bids to provide certain medical equipment and supplies to people with Medicare living in or visiting, competitive bidding areas. Medicare uses these bids to set the amount it pays for each item. All suppliers are thoroughly screened to make sure they meet Medicare requirements (like eligibility and financial, quality, and accreditation standards) before they’re awarded contracts.”

Grandfathered Suppliers and What to Know About Equipment Rental 

Not every supplier is required to be a Medicare contract supplier to be qualified to participate in the Competitive Bidding program. Your supplier may very well decide to participate in the program as a “grandfathered” supplier.

Simply put, you can continue renting equipment from your supplier if you were renting equipment at the time the program began. In most cases, this rule applies to oxygen and oxygen equipment. However, check with your DME supplier to see if it can apply to a mobility scooter.

If you find yourself contracting with a grandfathered client, you will only be able to work with them until your rental period has ended. After this point, Medicare will no longer cover any new equipment you may pay for in the future.

What To Do if Your Claim is Denied or You Don’t Qualify for Medicare Part B

One of the most pertinent concerns for most seniors is the amount they will have to pay out of pocket for a scooter. Those who aren’t qualified for Part B can find decent scooters anywhere from $750 - $2,000. You’ll find a massive selection of mobility scooters at Parentgiving that sit in this price range. Each order is backed by a top of the line customer support team that will aid you through the ordering process.

FAQs About Mobility Scooters and Medicare

What happens if my mobility changes?

If you think your mobility situation has changed, visit your doctor for a re-evaluation. They may prescribe a different type of mobility scooter. Depending on their analysis, you may need to go through the approval process again for changes.

How long does it take to get a scooter approved?

Typically, it takes Medicare 30-60 days to approve or deny your claim. Factors include how busy they are with claims, any missing information, and complexity of the claim, etc.

Can I rent a scooter instead of buying one?

Yes, you can rent a scooter. Renting is the best option if you have a temporary illness or injury and know you don’t need a scooter for years and years to come. or Keep in mind, with traditional Medicare, they will cover the cost of the purchase of a scooter, not a rental. 

What happens if my scooter is damaged?

If you damage your Medicare-provided scooter, let your supplier know and see what damage was done. Typically, the supplier can either repair it or replace it. The details for filing a claim will be answered by your DME supplier.

Find the Right Scooter at Parentgiving

If you’re qualified for Part B, your best course of action would be to visit a Medicare contracted DME supplier near you to receive coverage on your mobility scooter. However, if you don’t qualify, you can turn to Parentgiving to find the scooter you need to reclaim your mobility.For more mobility options, be sure to check out our 4 wheeler walking aid, extra large wheelchair rental, and our options in an electric lift for disabled people. Learn all about our offers at Parentgiving.com.