Medicare Part B (Medical Insurance) will cover power-operated vehicles such as scooters, and wheelchairs, as durable medical equipment (DME) that is prescribed by your doctor for use in your home. There are, however, some out-of-pocket expenses that are required to be paid by Medicare enrollees. For example, it is required that an enrollee pay 20 percent of the Medicare-approved amount.
Different types of durable medical equipment may be paid for by Medicare in different ways. Some equipment may be rented, while other types of equipment may be purchased. In some situations, the Medicare beneficiary may choose whether to either rent or to purchase the equipment.
It is important to note that Medicare will only cover the durable medical equipment such as a wheelchair if the enrollee’s doctor or equipment supplier is enrolled in Medicare. This means that the doctor or supplier accepts Medicare assignment. If the health care provider or supplier does not accept Medicare assignment, then Medicare does not limit how much can be charged for the medical equipment. In this case, the Medicare enrollee may also have to pay the entire bill at the time that he or she obtains the wheelchair (or other equipment that is being purchased or rented).
What is the Competitive Bidding Program?
If you reside in or visit certain areas of the United States, you could be affected by the Medicare Competitive Bidding Program when it comes to obtaining a wheelchair, or any other durable medical equipment. Medicare is phasing in this program in some areas of the country. This program changes the amount that Medicare pays suppliers for certain durable medical equipment (DME), and it also changes who may supply these items.
Under this program, suppliers submit bids in order to set the amount that they pay for the equipment and supplies. The qualified, accredited suppliers that have winning bids are then chosen as Medicare contract suppliers.
The Competitive Bidding Program is meant to help Medicare enrollees and Medicare save money. It also is intended to provide Medicare enrollees access to quality medical equipment, supplies, and services from trustworthy suppliers. In addition, the program may also help in limiting fraud and abuse within the Medicare program.
If you are enrolled in Medicare Part A and Part B (Original Medicare) and you get competitively bid equipment and supplies in competitive bidding areas, then Medicare may only help to pay for these equipment and supplies if they are provided by contract suppliers.
A contract supplier is not allowed to charge you more than the 20 percent co-insurance amount and any unmet annual deductible for any equipment or supplies included in the Competitive Bidding Program.
In order to determine how much a specific item will cost, talk to your doctor or other health care provider. This is because the specific amount that you owe can depend on a variety of different factors, such as other insurance that you may have, how much the supplier charges, and / or where you obtain your item.