Jack's Blog on Medicare Plan Choices

Scooters are known as Power-Operated Vehicles or POV for short. POV’s can provide vital mobility assistance for those with limited ability to walk or move around. Let’s break down what you need to know about Medicare coverage for POVs. 

I will list some key points below but let me start out with this: Medicare usually only covers scooters for use inside the home. If you are thinking that you need a scooter to get around outside while you use your cane, walker, or wheelchair inside, you are not a candidate for approval.

Coverage requirements:

1. You have a medical need for the POV to move around your home
2. You’re unable to use a manual wheelchair
3. You can safely operate the scooter
4. Your doctor and a supplier who are enrolled in Medicare both submit orders/prescriptions

Cost:

1. If approved, Medicare typically covers 80% of the approved amount
2. You’re responsible for the remaining 20% plus any applicable Part B deductible

Process:

1. You’ll need a face-to-face examination and a written prescription from a doctor
2. The scooter must be provided by a Medicare-approved supplier

As for Medicare Advantage plans:

1. These plans must cover at least what Original Medicare does, so they should cover motorized scooters under similar conditions
2. However, specific coverage, costs, and requirements may vary by plan

Steps to approval

1. Obtain a prescription: Your doctor must prescribe the scooter as medically necessary.

2. Complete a face-to-face examination with your doctor to evaluate your need for the scooter.

3. Get a written order: Your doctor must provide a detailed written order for the scooter.

4. Meet Medicare’s eligibility criteria:

1. You must have a mobility-related condition that impacts daily activities.
2. You can’t perform these activities with a cane or walker.
3. You can safely operate the scooter.
4. Your home can accommodate the scooter.

5. Choose a Medicare-approved supplier

6. Submit documentation: Your doctor and supplier will submit all necessary paperwork to Medicare.

7. Await approval: Medicare will review your case and decide whether to approve the scooter.

8. Pay your share: If approved, you’ll typically pay 20% of the Medicare-approved amount.

Remember, Medicare usually only covers scooters for use inside the home.

Here is my disclaimer.  I gather most of my information from Medicare.gov and to the best of my knowledge, it is accurate.  Please use this information as a guideline.

Before choosing an Advantage or Supplement plan, ensure you have a thorough understanding of Medicare itself. When it’s time to explore your options, don’t fall for a sales pitch from a single company or an agent representing only one provider.

At “More Plans More Choices,” I can provide you with side-by-side comparisons from various insurance carriers. More carriers plus more plans equals more choices.

Call me toll free at (888) 883-6074