As a person with mobility difficulties, you may think that a mobility scooter is just the thing you need. These devices can give you back your mobility, give you back a feeling of independence and help you enjoy your life to a much greater degree. Imagine being able to get around on your own, in your home, the grocery store, on vacation or anywhere else! However, purchasing a mobility scooter can be quite confusing. Will Medicare cover the entire cost of a scooter? Will your private insurance help you secure a mobility scooter? What are the differences in coverage among the U.S., Canada and the UK?
How Insurance Works
Mobility scooters are wonderful devices; however, they can be quite expensive.And the cost makes it imperative that you find financial assistance. In the U.S., Medicare will cover up to 80% only of the scooter cost, if at all. If you have private insurance, your carrier may cover the remaining 20%, though this will vary among insurance companies and insurance policies.
How will you determine if you are eligible for Medicare coverage? What steps must you take to begin the process?
U.S. Medicare will only provide coverage for a mobility scooter if you have a prescription for one and a CMN (Certificate of Medical Necessity). And these must claim that you need the scooter for indoor use within your home. Medicare will not provide any coverage if the scooter is for outdoor use only.
Step 1 – Visit Your Doctor
Step 1 is to visit your doctor. You will need a prescription for the mobility scooter, so discuss your needs with your physician and find out if you qualify. Remember, the scooter must be for primary use within your residence, otherwise, Medicare will not pay anything.
Step 2 – Obtain a CMN
Medicare will also require aCertificate of Medical Necessity (CMN) prior before it can extend any coverage to you. You and your doctor must fill out and submit the appropriate CMN paperwork.
Please note that Medicare requires the prescribing physician be a rheumatologist, orthopedist, neurologist or a psychiatrist (a rehabilitation physician).
A general physician cannot order your mobility scooter.So you will need to seek the assistance of a specialist. Your general physician can make recommendations to the appropriate doctors in your area, if you do not currently have a doctor in any of the qualifying specialty fields.
Step 3 – Submit Your Claim to Medicare
The final step in the process is to submit your claim to Medicare. Your prescribing doctor will actually be the person submitting your claim. It can take some time before your claim is processed and approved, so don’t expect an immediate response.
What Can You do to Ensure Acceptance?
How can you ensure that your claim is approved? What can you do to make sure your claim stands the best chance to be accepted by Medicare? First, make sure you meet one of the following criteria:
• You are unable to get around inside your home without a mobility scooter
• You are unable to operate a manual wheelchair
• You are able to operate the controls of a mobility scooter
• You are able to move safely into and out of a scooter
With What Can the Scooter Merchant Help You?
Many dealers and merchants are able to provide you with assistance throughout the entire Medicare application and approval process. In addition, if you qualify for a mobility scooter through Medicare, there is no charge for their assistance. This can save you time, money and hassle. Dealers of mobility scooters often have Medicare and insurance specialistswho work in-house to help get customers approved.
You will have to contact your merchant of choice through their website or toll-free number and speak with a specialist. The specialist will ask specific questions to determine if you meet any of the categories listed above for Medicare approval. They will also ask you for your prescribing physician’s contact information. The merchant’s customer care representative will then contact your doctor and submit your claim to Medicare – without you having to handle any of the paperwork.
What Are the Differences in Medicare Coverage?
In the U.S., Medicare will cover up to 80% only of the total cost of your mobility scooter. Your private insurance will have to pay the remaining balance. Or you will need to pay out of pocket.
For people who live in Canada, Medicare does not cover the cost of a mobility scooter. Although, insurance, veterans’ organizations and other charitable organizations can help defray the cost of buying a mobility scooter.
In the U.K., persons with disabilities also have to rely on insurance or a veterans’ organization to help pay for the cost of a mobility scooter.
SpinLife.com, a successful mobility scooter merchant has marked on their website which mobility scooters qualify for medicare or private insurance or not. They also fill out all your medicare paperwork so you are not overwhelmed by the process.
To see which mobility scooters are eligible under U.S. Medicare, SpinLife.com – a leading online mobility devices dealer – has labeled all itseligible scooters on its website. In the screen shot below, you’ll notice a green M and blue I, each indicates the scooter is covered by Medicare and Insurance, respectively. Click on the screen shot below to see scooter listings eligible for Medicare or Insurance. This is one example at SpinLife.com