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Does Medicare cover wheelchairs?

Just the Essentials...

  • Original Medicare does offer coverage for mobility/ambulatory devices such as manual wheelchairs, powerchairs/electric scooters, walkers, and canes.

  • Original Medicare only covers the cost of these devices if they have been deemed medically necessary by a physician.

  • Once assignments are accepted by a physician or medical provider, the insured party must pay 20% of the amount approved by a doctor or supplier to cover the cost of the medical equipment; normal insurance deductibles also apply.

Though Medicare Part B does cover wheelchairs and other vital mobility equipment, Medicare Part C – or Medicare Advantage – also offers this crucial coverage and potentially much more. If you’re worried about getting the benefits you need from Medicare, call (800)950-0608 to compare plans with a licensed agent.

Ambulatory/Mobility Assistance Devices: Why do we need them?

Ambulatory devices, such as canes and walkers, are crucial for a variety of reasons, including but not limited to the mitigation and prevention of injuries due to loss of balance and falls, support for sore or weakened/arthritic joints (particularly hip and leg), and general support for otherwise delicate leg musculature that may be unable to hold up the weight of the body without assistance.

Mobility devices (ie. wheelchairs, scooters, etc.) provide both the elderly and those with specific disabilities the opportunity to be mobile. This is important because it is crucial for seniors to keep some form of mobility to maintain functional independence. Also, mobility devices have been shown to decrease and even prevent pressure sores and deformities, and help recuperate respiratory and digestive health. Studies show that about 1% of the total population or about 65 million people require a wheelchair for mobility.

Slips, trips, and falls are the most common form of injury for seniors. Why is this, and how can ambulatory/mobility devices help?

Some seniors may think, “I don’t have any mobility needs or impairments that could be assisted by wheelchairs or walkers. Why should I worry about wheelchair coverage if it doesn’t apply to me right now?”

Age is inevitable. As our bodies grow older, certain conditions can arise at any time that require the use of medical devices to maintain mobility and independence. Some aspects of the body may not operate as well as they used to and can become dysfunctional. Particularly affected by age are our bones, muscles (eyes included), as well as the inner ear and a portion of a crucial cranial nerve. Slips, trips, and falls are strongly related to the following conditions that can affect the elderly:

PVD or peripheral vestibular dysfunction: This is a condition that affects the inner ear and related cranial nerve, causing them to become dysfunctional. This particular condition does not only affect the elderly, but chances of a diagnosis of PVD or peripheral vestibular dysfunction increase with age. When diagnosed with PVD, the most common symptom of this condition is BPPV or Benign paroxysmal positional vertigo. This is a fancy way of saying that a feeling of vertigo or extreme dizziness/lightheadedness is triggered by certain changes in your head position, such as tipping the head up or down. This can easily cause individuals to lose their balance and fall down.

Optical Degradation: Conditions/Diseases of the eye. Glaucoma, cataracts, and general vision loss due to age-related macular degeneration are three conditions that greatly affect the elderly. If you cannot see well, it stands to reason that it would be more likely to slip, trip, and fall.

Woman in wheelchair with her dog at sunset

Why are slips and falls so dangerous?

One out of every four senior aged Americans fall down every year according to the National Council on Aging. These falls result in a variety of injuries that can lead to hospital admittance, permanent loss of mobility, and sometimes, even loss of life. Falls are so dangerous for seniors for many reasons:

  • Osteoporosis – Osteoporosis is the condition in which our bones become weak and brittle. This is because, though the body is still constantly replacing old bone tissue with new bone tissue, our body over time can no longer keep up with this replacement. This leads to a honeycomb appearance in our bone structure, which makes them more susceptible to breaks and fractures, especially after a particularly nasty fall.
  • Head injuries – These types of injuries can cause brain damage and internal bleeding that could be potentially fatal.
  • Minor Injuries – Though minor injuries like cuts, scrapes, and bruises can seem like not a big deal, the immune system of the elderly is much weaker than that of a younger person, making them susceptible to infections. Also, the ability for the blood clot lessens over time, meaning that bruises can be much worse than they appear on the surface.

All of these injuries may eventually lead to the need for a wheelchair, powerchair, walker, or other ambulatory or mobility device on a short or even long term basis. This is why so many seniors are concerned that costs for these devices will be covered by their Medicare Plan.

If you would like to explore Medicare Advantage plans for yourself and see if they are right for you, please give us a call at (800) 950-0608 to speak with a live agent or compare quotes online using our free tool.

How is Medicare Advantage different from Original Medicare?

Unlike Original Medicare (Parts A and B), Medicare Advantage (Part C) is a selection of health insurance plans that provide regular Medicare benefits through a private-sector health insurer. These plans provide innovative support as well as cost reductions nationwide. Plans under Medicare Part C must meet or exceed Original Medicare, and many seniors consider enrolling in a Medicare Advantage plan because of their additional benefits such as coverage for hearing, dental, vision, transportation services, and OTC (over the counter) allocations. Prescription drug coverage is also available under Medicare Advantage plans, allowing you to consolidate everything under one plan to reduce costs.

Medicare can be confusing, but it’s important to determine you’ll have the coverage you need for wheelchairs, motorized wheelchairs, walkers, and more. If you are interested in learning more about Medicare Advantage, give us a call today!

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