In the last 15 years, the motorized wheelchair (also known as the power wheelchair) has made it possible for hundreds of thousands of Americans to regain their mobility and live their lives independently. The vast majority of these power wheelchair owners received their equipment through Medicare's power mobility benefit. What is the power mobility benefit and how does a person qualify for an power wheelchair? The next few paragraphs will give you some insight into Medicare's guidelines.
Medicare spends around .5 Billion annually on power wheelchairs and power operated vehicles (mobility scooters). Medicare considers a beneficiary's ability to safely participate in one or more Mobility Related Activities of Daily Living (MRADLs). These activities of daily living include dressing, grooming, toileting, bathing and eating in customary locations within the home (which can include assisted living centers). In order to qualify for an power wheelchair, a person must need assistance with one or more of these daily living activities.
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This means if a person only needs help going to the grocery store, the shopping mall or someplace else outside the home, Medicare will not pay for an power wheelchair. The person must have at least one daily living activity need inside the home to be considered for an power wheelchair.
If a person needs mobility assistance inside the home to perform daily living activities, the next thing Medicare is going to examine is if a person can get by safely with a cane, walker or manual wheelchair. Since these are less expensive items, Medicare wants to try them first. Many people may be able to get around with a cane or walker for part of the day, but then weaken or get tired as the day goes on. Others may not be able to safely walk the home with a cane or walker due to frequent falls. Many people will not be able to propel themselves in a manual wheelchair due to lack of strength or other upper body conditions.
Once a person has determined that he or she needs additional mobility assistance inside the home and other mobility aids (cane, walker, wheelchair, etc.) have been ruled out, it is time to consult a physician or medical equipment company to initiate the power wheelchair evaluation and approval process.