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Consumer Information
This information provided is general information about the potential reimbursement of the products Pride Mobility Products manufacturers. Pride Mobility Products recommends that you contact your insurance carrier for detailed information regarding payment guidelines and coverage criteria.
Scooters
Most scooters made by Pride Mobility Products Corp. are recognized and qualify for potential reimbursement under Medicare and other Health Care Insurance Companies as a power operated vehicle or (P.O.V.).
If you need a scooter for mobility and you meet your insurance's coverage guidelines, they may pay for all or part of the cost of the scooter. 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 scooter for you.
Power Operated Vehicles (POVs)/Scooters
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:
Face-to-face examination:
The report of the face-to-face examination (see Policy Article) should provide information relating to the following questions:
- What is this patient’s mobility limitation and how does it interfere with the performance of activities of daily living?
- Why can’t a cane or walker meet this patient’s mobility needs in the home?
- Why can’t a manual wheelchair meet this patient’s mobility needs in the home?
- Does this patient have the physical and mental abilities to operate a POV (scooter) safely in the home?
A POV that is beneficial primarily in allowing the patient to perform leisure or recreational activities will be denied as not medically necessary.
If a POV is covered, a wheelchair provided at the same time or subsequently will usually be denied as not medically necessary.
If you feel you meet these requirements, you may be eligible to receive the most stylish, best performing and most reliable scooter available on the market today. For an authorized Pride dealer near you contact Pride Mobility Products Corp. at (800)-800-8586. |
