Electric Mobility Scooters

Will Medicare Cover Mobility Scooters or an Electric Scooter?

Medicare will cover electric mobility scooters. However, you must be able to show you have an honest medical need for one and the primary use must be for moving around your home. In other words, it just can't be something that would be nice to have or primarily for use outside the home. However, you must follow the steps below to ensure that Medicare pays for the equipment:

Only your doctor can prescribe the equipment for you, so do not order anything until you have visited your doctor no matter what the sales person tells you.
The doctor must document the need for an electric scooter in your medical records and give you a signed and dated order (prescription) for the equipment.
The order must be received by the supplier before Medicare is billed and it must be kept on file by the supplier.

If you receive your Medicare through a Medicare Medical Advantage Plan (HMO, PPO) it is likely you will have to follow the plan's steps for approval and purchase of a scooter. Call your plan's customer service number and ask how you get coverage for an electric mobility scooter.

How Do I Qualify For a Scooter covered by Medicare?

You must have Medicare Part B coverage and your doctor must have assessed your needs, documented the need in your medical records, and wrote you an order (prescription) for the equipment (scooter). The supplier must have the order on file before billing for the scooter. In addition, the need for the scooter must meet the following criteria:

You cannot walk on your own, even with the support of other mobility equipment
You have weakness in your upper body caused by injury or illness and cannot use a manual wheelchair because of upper body weakness
You would have to spend most of your time in bed or a chair without the scooter
You can safely get on and off the scooter, as well as sit on it and work the controls
You must need the scooter to help you move about independently. Medicare will not cover a scooter if the stated need is to prevent an injury.

How Much Does It Cost to Rent or Own a Mobility Scooter?

After you have paid your annual deductible, you will pay 20 percent of Medicare-approved amounts for the mobility scooter purchase, or rental and maintenance. Those costs may be higher if the supplier doesn't accept assignment. Scooters are in the "Capped Rental" category, which means you may choose to rent or purchase it.

Once Medicare has made 10 monthly rental payments, you will be given an opportunity to purchase the scooter. The supplier will send you a Purchase Option letter in the ninth month of the rental. You will have 30 days to reply.

If you reply and want to buy the electric scooter:

Medicare will make three more payments and the chair is yours
You will be responsible for scheduling maintenance for your scooter (Medicare will cover 80 percent of maintenance costs)

If you do not answer or choose to continue renting:

Medicare will make a total of 15 rental payment and the scooter is yours to use as long as you need it.
The supplier keeps ownership of the scooter and is responsible for maintaining it
You will be charged a maintenance and service fee every six months. Medicare will pay 80 percent of the maintenance and service fee.

Where Do I Purchase an Electric Mobility Scooter?

You will save money if you order your scooter from a Medicare approved provider. An electric scooter dealer must meet strict standards and will have a Medicare supplier number. You may also buy your mobility scooter from any store that sells them. However, if the supplier from which you order your electric scooter is not enrolled in Medicare, Medicare will not pay for the equipment.

Things you should think about before you choose a supplier:

There are two types of Medicare suppliers: participating suppliers and those who are enrolled, but have chosen not to participate.
Participating suppliers will not charge more than the Medicare allowed amount.
A Medicare approved provider who does not want to participate can charge more than the Medicare-approved amount. However, they cannot charge more than 15 percent above the Medicare-approved amount. They may also ask you to pay the entire bill when you pick up the electric scooter. In this situation, Medicare will send the reimbursement directly to you. However, be prepared to wait; it may take a couple months to receive payment.
If you receive your Medicare coverage through a Medicare Advantage Plan (HMO or PPO), it is likely that the plan will have its own steps for the purchase. In addition, the plan may have restrictions on the supplier you buy a scooter from. It is important to know that your health plan must supply at least what Medicare covers.

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