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Power Chairs Covered By Medicare

Power Chairs Covered By Medicare

If you need a power wheelchair or power scooter, follow these two steps to get Medicare coverage. 1. Start with your doctor. If you think you need a power wheelchair or scooter, ask your doctor about it. Or, your doctor may be the one to recommend a wheelchair or scooter to you. In any event, before you get your wheelchair or scooter, you must have an office visit with your doctor. The visit should take place no more than 45 days before the DME order and should deal with the medical reasons you need the wheelchair or scooter. Your provider must sign an order or fill out a prescription or certificate that states that you need the power wheelchair or scooter to function in the home. The order must state: Your health makes it very hard to move around in your home even with the help of a walker or cane; You have significant problems in your home performing activities of daily living such as getting to the toilet, getting in and out of a bed or a chair, bathing, and dressing; If you need a power wheelchair, you cannot use a manual wheelchair or scooter, but you can safely use a power wheelchair and The required office visit with your doctor took place. The equipment must be necessary for you in the home but you can also use it outside the home. You can get only one piece of equipment to address your at-home mobility problem. Your doctor or other provider will determine what equipment you need based on your condition, what equipment can be used in your home, and what equipment you are able to use. 2. Use the Right Kind of Supplier. Once you have the doctor’s order or prescription, you must take it to the right kind of supplier to get coverage. Be sure only to use suppliers with approval from Original Medicare or your Medicare Advantage Plan. What kind of Medicare coverage you have and where you live will decide which supplier you use. Original Medicare If you have Original Medicare, be aware that the type of suppliers Medicare has approved for you will depend on how Medicare pays for equipment in your area and the kind of DME you need. In many areas, called competitive bidding areas, Medicare will usually only pay for most DME from a select group of suppliers known as contract suppliers. In other areas, you can use any supplier that Medicare has signed up with Medicare. Call 1-800-MEDICARE or go www.medicare.gov/supplier to get a list of suppliers Medicare has approved for you. Remember to find out if the competitive bidding demonstration affects you since it decides the suppliers you can use and the amount you will pay. Also, if you live in or plan to travel to a competitive bidding demonstration area and need DME that is included in the demonstration, make sure you are informed about the types of suppliers you must use and your costs for DME. If you live in an area that is not part of the competitive bidding demonstration, you may need to rely on different kinds of suppliers. Medicare Advantage If you have a Medicare Advantage Plan (like an HMO or PPO), you must follow the plan’s rules for getting a wheelchair or scooter. The plan may require you get its approval before you get your DME. It may also ask you to use suppliers in the plan’s network. You may get little or no coverage if you use suppliers outside of the plan’s network. Your plan may also have a list of preferred brands of power wheelchairs and scooters. These brands will cost you the least while you are a plan member. Make sure you use preferred brands when possible to limit your costs. Call your plan to find out what you must do to get your wheelchair or scooter covered. People in Medicare Advantage Plans will not be affected by the competitive bidding demonstration.
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Power Chairs Covered By Medicare

If you have Original Medicare, be aware that the type of suppliers Medicare has approved for you will depend on how Medicare pays for equipment in your area and the kind of DME you need. In many areas, called competitive bidding areas, Medicare will usually only pay for most DME from a select group of suppliers known as contract suppliers. In other areas, you can use any supplier that Medicare has signed up with Medicare. Call 1-800-MEDICARE or go www.medicare.gov/supplier to get a list of suppliers Medicare has approved for you. Remember to find out if the competitive bidding demonstration affects you since it decides the suppliers you can use and the amount you will pay.
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Power Chairs Covered By Medicare

Note If your current supplier isn’t a Medicare contract supplier, you may still be able to stay with that supplier if they decide to participate in the program as a “grandfathered” supplier. Suppliers that don’t get Medicare contracts can decide to become “grandfathered” suppliers. This means a supplier may continue to rent equipment to you if you were renting the equipment when the program started. This rule applies to oxygen, oxygen equipment, and certain rented equipment. You may continue using the “grandfathered” supplier until the rental period for your equipment ends. If you start renting additional equipment from a “grandfathered” supplier after the program starts, Medicare won’t pay for the new equipment. If you’re renting equipment that’s eligible for grandfathering, your supplier will let you know in writing 30 business days before the program begins whether it will or won’t become a “grandfathered” supplier. What happens if my supplier decides not to become a grandfathered supplier? You need to decide whether to continue to rent from your current supplier and pay all the costs, or switch to a Medicare contract supplier. A supplier that doesn’t have a contract and decides not to become a grandfathered supplier is required to notify you and pick up the item from your home after the program starts. Your supplier must notify you these 3 ways before it can pick up the item: The supplier must send you a letter at least 30 business days before the program starts telling you that it will no longer provide rental items to you after a certain date. This letter will tell you the date that a Medicare contract supplier must start to provide you with the rented item. The supplier must call you 10 days before picking up the item to make arrangements for pick up at an agreed upon time. The supplier must call you again 2 business days before picking up the item. A supplier that isn’t grandfathered can’t pick up a medically necessary item before the end of the last rental month for which the supplier is eligible to get a rental payment. If you change to a Medicare contract supplier, your old supplier should work with the contract supplier so there isn’t a break in service. Keep the pickup slip or other documentation from the old supplier that shows you no longer have the item.
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Power Chairs Covered By Medicare

Step 1 Visit with your physician for a face-to-face examination and discuss your mobility options. Medicare now requires a face-to-face examination with your physician prior to writing a prescription for a power mobility device.During your exam, your physician must first consider the use of cane, walker, and manual wheelchair before considering a scooter or power wheelchair. If your physician feels that your mobility needs must be resolved with a scooter or power wheelchair, this must be supported in your medical records and a prescription can be written. A Physical Therapist or Occupational Therapist may also conduct an additional assessment if your physician deems it necessary. Step 2 Have your physician fax or mail the written prescription and medical records to your Mobility Supplier. The Mobility Supplier must receive the written prescription and supporting documentation (medical records) within 45 days from the date of your face-to-face examination.Once received, the Mobility Supplier will work with you and your physician to determine the appropriate scooter or power wheelchair model for your needs.If you have Traditional Medicare as your insurance and are looking for a mobility scooter, standard power wheelchair, or manual wheelchair, Medicare’s Competitive Bidding program may now require you to obtain your equipment from certain suppliers.Find your mobility supplier.Request to be contacted by a medical supplier. Step 3 Your Mobility Supplier will conduct a home assessment to ensure that you have adequate access and maneuverability space.*The primary reason for a power mobility device is to compensate for your mobility limitations within your home and your ability to perform activities of daily living including toileting, grooming, bathing, dressing and eating. Therefore, it is critical to determine if your home environment will support the use of a scooter or power wheelchair. Step 4 Your Mobility Supplier will order the power mobility device prescribed by your physician or treating practitioner, deliver it to your home and instruct you on how to operate it. Delivery of the scooter or power wheelchair must be no more than 120 days following your face-to-face exam.

Power Chairs Covered By Medicare

Power Chairs Covered By Medicare
Power Chairs Covered By Medicare
Power Chairs Covered By Medicare

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