To obtain a manual wheelchair through Medicare, you must follow a specific clinical and administrative process. Medicare covers manual wheelchairs that are deemed medically necessary for everyday mobility, typically covering 80% to 100% of the cost when working with an approved supplier.
The process involves the following steps:
- Physician Prescription: You must first obtain a prescription from your healthcare provider. This documentation must demonstrate medical necessity, detailing your mobility limitations and explaining why other aids, such as canes or walkers, are insufficient for your needs.
- Functional Assessment: You will need to undergo a functional mobility assessment, often conducted by a therapist or a certified Assistive Technology Professional (ATP). This evaluation ensures the specific wheelchair model and features suit your physical capabilities and lifestyle.
- Documentation for Custom Features: If you require lightweight models or custom seating, such as pressure-relief cushions or tilt-in-space mechanisms, additional documentation from an ATP-led evaluation is required to justify these features to Medicare.
- Supplier Coordination: Once the clinical requirements are met, the paperwork is submitted to Medicare for approval. MedEquipped assists with insurance navigation and coordination, typically resulting in a delivery timeline of 30 to 60 days.
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