If you need a power chair for mobility and you meet your insurance's coverage guidelines, they may pay for all or part of the cost of the power chair. Coverage criteria and payment amounts will vary depending on the type of insurance you have. Most heath care insurance companies, including Medicare, have minimum requirements that need to be met before they will purchase a power chair for you.

Motorized/Power Wheelchair

Medicare has changed the coverage criteria and documentation requirements for Power Mobility Devices for dates of service on or after May 5, 2005.

Medicare has modernized the policy and replaced the “Bed or Chair Confinded” requirements with consideration now given to the beneficiary’s ability to safely and in a reasonable time fream participate in one or more Mobility Related Activities of Daily Living (MRADLs).

A face-to-face examination with your referring physician is required prior to any PMD being prescribed.

Medicare looks for the following information from your physician:

1. What is the patient’s mobility limitation and how does it interfere with the performance of activities of daily living?
2. Why can’t a cane or walker meet the patient’s mobility needs in the home?
3. Why can’t a manual wheelchair meet the patient’s mobility needs in the home?
4. Why can’t a POV meet the patient’s mobility needs in the home?
5. Does the patient have the physical and mental abilities to operate a power wheelchair in the home?

Payment is made for only one wheelchair at a time. Backup chairs are denied as not medically necessary. One month' s rental of a wheelchair is covered if a patient-owned wheelchair is being repaired. Reimbursement for the wheelchair codes includes all labor charges involved in the assembly of the wheelchair and all covered additions or modifications. Reimbursement also includes support services, such as emergency services, delivery, set-up, education, and on-going assistance with use of the wheelchair.