Mobility and Medicare Coverage

Mobility, the ability to get around easily, often decreases with age. The U.S. Department of Health and Human Services estimates that as much as 37 percent of people 65 and older have limitations on their activities due to less mobility. Movements like reaching, bending, going up and down stairs, and getting in and out of the bathtub become difficult. Even walking can become harder as some older people have problems with their gait and balance.

Many of the physical changes that happen with aging are normal, but can affect mobility. Some of those changes include:

Arthritis in the jointsLess physical energySlower reflexesLoss of bone tissue (osteoporosis, especially in women)

Exercise and staying as active as possible will help an elderly person maintain more of their mobility and strength. But sometimes the lack of mobility becomes serious enough that it begins to affect all aspects of life. Those affected don’t socialize as much, give up enjoyable activities, and frequently become housebound.

This lack of mobility is often combined with a fear of falling. Older people often fear that they’ll break a hip or have another falling injury that would result in having to move out of their home. This can lead to a loss of their independence or an increased dependence on others for help. It can begin to feel like they are losing control over daily life decisions.

Mobility Aids
Fortunately, mobility aids like canes, walkers, electric wheelchairs, and electric scooters can help those with decreased mobility safely stay in their homes and maintain their independence. The correct type of mobility aid is determined by several factors—overall strength and balance are the most important. If you have good body strength and balance, using a cane will probably be the right mobility aid. If you aren’t as steady on your feet, you may need the extra support of a walker or rollator (wheeled walker). But if a cane or walker isn’t suitable for your needs, your doctor may suggest a power wheelchair or power scooter.

In order to get a mobility aid, you’ll need to be evaluated by your doctor first. Here are some of the specific things they will measure:

Your upper-body strength: You need upper-body strength to be able to balance yourself on a scooter, which has less support than a power wheelchair.Posture: Related to balance, you also must be able to maintain an upright posture to stay on a scooter. An electric wheelchair offers much more reinforcement for your weak upper body and posture.Arm, hand and leg strength: Scooters require that you are able to work hand controls and brakes. For instance, if you don’t have the arm and hand strength required, you may need a power chair with a joy-stick control.

After your evaluation, you will know which mobility aid is best for you. You can begin looking into different models of power chairs and scooters, electric wheel chair accessories, or scooter options.

Mobility Aids and Your Medicare Coverage
There are guidelines you must follow in order to have Medicare pay for most of your mobility aid.

You must have your evaluation with a doctor or other qualified health provider.The evaluation must say that you need a mobility aid for a medical condition.It must be documented and submitted to Medicare. This is called a “Certificate of Medical Necessity.”Like a prescription, you will need this information in order to get your new mobility aid.When you are shopping for your mobility aid, you will need to be sure that the wheelchair or scooter supplier is Medicare-approved or “assigned” by Medicare.”

Accepting “assignment” simply means that the supplier has agreed to accept what Medicare will pay. Your mobility aid is covered under Part B of Original Medicare. You may have to pay up to 20 percent of the cost after meeting your deductible.

NOTE: If you have a Medicare Advantage Plan or a Medi-Gap insurance plan to pay for additional, non-covered services, you will need to check your specific plan.

How Do I Find a Medicare-assigned Supplier?
To find a supplier that is Medicare-approved, look on the Medicare website, www.medicare.gov, under “Find Suppliers of Medical Equipment in Your Area” or call 1-800-MEDICARE (1-800-633-4227). The dealer must have a Medicare supplier number and must also meet strict standards.

Adapting to Increased Mobility
When you have your electric wheelchair or power scooter, you’ll need some time to learn to use your equipment safely. Allow time to adjust to this new device.

Some important things to do include:

Make sure your home is wheelchair “accessible,” not just via ramps or large doorways and entrances. You will need to have clear pathways inside your home for safe and easy maneuvering.Learn all you can about your chair or scooter by reading the owner’s manual. Pay special attention to battery information and suggested maintenance.You may want to look into vehicle transportation options for your wheelchair or scooter.
Accessorize your mobility aid with custom features like baskets for carrying items, mirrors for clear, safe vision, and cup holders, etc.

After you have adapted to using your aid and you feel more comfortable, you will notice how much independence you have regained. Having increased mobility allows you to be more involved with family, friends, and the life activities that you thought you had lost.

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