By Maria Basso Lipani, LCSW
©2008-2010
Summary: The power wheelchair can substantially enhance independence for those who are physically disabled. For those who require this piece of mobility equipment due to a medical condition, it is possible that Medicare will pay for a substantial portion of the cost. Although power wheelchairs are similar to mobility scooters, there are significant differences.
Dear Maria: My mother has recently been diagnosed with ALS and I want to learn everything I can about equipment that can help her maximize her independence for as long as possible. She is still able to walk at this time, but I know that there will come a time when she cannot. I’m assuming that the first step would be to get her a mobility scooter and then later, a power wheelchair, is this right? Ann, Redding, Pennsylvania
Dear Ann: When walking first becomes difficult, most people look to a cane or walker first. If neither of these pieces of equipment provides sufficient stability, a manual wheelchair would be next. If a person is unable to propel a manual wheelchair on his or her own, Medicare may pay for an electric or motorized scooter. If a scooter becomes no longer sufficient, then yes, a power wheelchair would be next.
Although the requirements for reimbursement from Medicare are similar for a scooter and a power wheelchair, there are very different standards for what makes each piece of equipment medically necessary.
Generally speaking, a person would qualify for a power wheelchair only when a qualifying diagnosis such as ALS has caused him or her to lose the upper body strength to sit upright in a scooter and operate one safely. So long as your mother is able to do this, the scooter would likely be the most appropriate piece of equipment.
The most important thing to keep in mind when ordering a power wheelchair (or a scooter for that matter) is that your mother speaks with her physician first, to obtain a prescription. The prescription is what she’ll give to the vendor. Before writing the prescription, the physician must carefully document the need for a power wheelchair in her medical record indicating the reasons that he or she feels this piece of equipment is essential to her day-to-day functioning and why. If this process is not followed, Medicare may not pay.
If your mother does require a power wheelchair at some point, chances are she may also need a lift. Power wheelchair lifts may or may not be sold by the same vendor, so it would be important to ask. Although they are not a covered benefit under most insurance, they offer significant benefits with regard to transportation as well a entering or exiting a home.