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Sometimes due to injury, recovery from surgery, a disability, or decreased mobility as you age, you may need to use a wheelchair. If it will be for temporary use, you may just rent a wheelchair. But for permanent use, you should familiarize yourself with different types and features of wheelchairs.
Types of wheelchairs
There are basically two types of wheelchairs - manual and electric (or power) wheelchairs.
- Manual: A manual wheelchair is designed for people who have enough upper-body, arm, and hand strength to self-propel the wheels of the chair. You must also have sufficient balance and posture to sit upright in the wheelchair because there is not as much back support in this type of chair.
- Electric or power: Electric wheelchairs are for people who need support for their upper body and who are unable to move a manual chair with their arms and hands. A power chair has a more supportive seat and often a headrest for people who aren't able to hold themselves upright.
What Type of Chair is Best for Me?
Your doctor will need to determine which type of wheelchair is right for you. His evaluation will look at your ability to move as mentioned above - balance and posture while sitting, upper-body strength, and use of your arms and hands. He will also check the following:
- Transfer: Your ability for transfer safely in and out of the wheelchair.
- Use of the controls: Your ability to stay safely in the chair and use the controls.
- Your vision: Your vision must be adequate so that you can see to operate the controls, see ahead and around you while moving in the wheelchair.
If your doctor has decided that you are able to operate a manual wheelchair, he will document that you have a "medical necessity" for the wheelchair. He will then write a prescription for your chair. Both the documentation and prescription (also called an order) are needed for Medicare to cover most of the cost of your wheelchair.
Now that you have your prescription, you can begin to shop for your manual wheelchair.
What Features Do I Want in My Manual Wheelchair?
In the past, there was only one kind of manual wheelchair that everyone used. Now there are all types of models—folding wheelchairs, sports wheelchairs, travel wheelchairs, and even shower wheelchairs. You will most likely choose between a folding and a rigid-frame manual wheelchair.
Some things to consider about your choice:
Will you be driving or traveling with someone with your chair?
- Folding frame wheelchairs: This type of chair is a standard wheelchair and very sturdy, but can still be folded sideways as needed. However, it is fairly bulky and heavy to transport, and you would likely need help to load it into your vehicle. Although this style is more convenient for travel, it isn't as durable as the rigid frame model.
- Rigid frame wheelchairs: This style is also foldable for transport. Although it has a rigid frame, they are usually made of lighter weight aluminum that you can easily load by yourself.
Keep in mind that your doctor or occupational therapist has evaluated you for a chair with specific features. Factors they have considered are:
- Your age, weight, height, gender and your ability level.
What Specific Features are Important?
Here are some questions to answer when shopping, after following the doctor or therapist's orders:
- Is the chair mainly for indoor or outdoor use?
- What form of transportation will I be using?
- How many hours will I be spending per day in my wheelchair?
- Will I have someone available to help me with my chair?
- Will I have wheelchair ramps at my home or will I use a chair lift?
The answers to these questions will help you know which features you will need for your manual wheelchair.
Will Medicare pay for my manual wheelchair?
Manual wheelchairs are considered "Durable Medical Equipment" under Medicare guidelines. Most of the cost of your wheelchair will be covered under your Original Medicare Part B plan. You will have to pay 20 percent and meet your yearly Part B deductible.
In order for your wheelchair to be covered, remember the requirements:
- It must be medically necessary, as determined by a doctor
- Your doctor has documented this information for Medicare
- You have a "Certificate of Necessity" (like a prescription)
- You must purchase your wheelchair from a Medicare-approved supplier
Changes to Medicare coverage for Durable Medical Equipment
As of January 2011, Medicare has been phasing in a new program for Durable Medical Equipment called "competitive bidding" to help save you and Medicare money and ensure that you get quality equipment, supplies, and services. Under this new rule, you must use specific suppliers in some areas of the country, or Medicare will not pay for the item.
This rule is currently effective in several metropolitan areas in the following states: CA, FL, IN, KS, KY, MO, NC, OH, PA, SC, and TX. If you live in one these areas—or get a wheelchair while visiting one of these areas—you will have to use a supplier that participates in the competitive bidding program. Beginning in 2012, the program is scheduled to expand to an additional 91 metropolitan areas, and by 2016, it will be effective in regions in all 50 states.
Be Informed
Be sure you understand your Medicare coverage for wheelchairs. You must follow all the guidelines. Doctors, providers, and suppliers must be Medicare-approved. For more information on coverage and the competitive bidding rules, go to www.Medicare.gov or call 1-800-MEDICARE (1-800-633-4227).
Be Safe in Your Manual Wheelchair
When you are a beginner, using your wheelchair may feel awkward, but give yourself time to become acquainted with how it operates. It's especially important that you pay attention to safety while in your chair.
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