What are the Insurance Options for Assistive Technology?
There are several insurance options available to help cover the cost of assistive technology, specifically custom power wheelchairs. The primary sources include:
Medicare: This federal program covers power wheelchairs as durable medical equipment (DME) when they are deemed medically necessary to perform mobility-related activities of daily living within the home. Coverage typically pays for 80 percent of the cost after the deductible is met. This requires a face-to-face evaluation by a practitioner and a Standard Written Order.
Medicaid: State-specific Medicaid programs and waivers are available in states like New York, Georgia, and Michigan. These often provide enhanced access for low-income individuals and can cover a significant portion of the costs, sometimes up to 95-100 percent.
Private Insurance: Providers such as Blue Cross Blue Shield or Aetna often mirror Medicare guidelines but may offer more flexibility. Depending on the specific plan, they typically cover between 70 percent and 90 percent of the costs after deductibles. Prior authorization and a physician’s prescription are generally required.
At MedEquipped, we assist by coordinating the necessary documentation and clinical evaluations to navigate these insurance requirements, aiming to streamline the approval process within 30 to 60 days.
Related FAQs
-
How does Medicaid Insurance Cover Wheelchairs?
Read More »: How does Medicaid Insurance Cover Wheelchairs?Medicaid wheelchair insurance is a state-federal program that provides coverage for durable medical equipment (DME), including power wheelchairs, for eligible low-income individuals. Unlike Medicare, which typically covers 80% of costs, Medicaid often provides full coverage for advanced mobility solutions like…
-
How do I Appeal a Denied Medicare Power Wheelchair Claim?
Read More »: How do I Appeal a Denied Medicare Power Wheelchair Claim?If your Medicare power wheelchair claim is denied, you have a structured pathway to appeal the decision. You must initiate the process by requesting a redetermination within 120 days of receiving your denial notice. During this stage, it is crucial…
-
How do I Qualify for Medicare Coverage of a Power Wheelchair?
Read More »: How do I Qualify for Medicare Coverage of a Power Wheelchair?To qualify for Medicare coverage of a power wheelchair, you must meet specific medical necessity and eligibility criteria. First, you must have Medicare Part B coverage and a mobility impairment, such as severe arthritis or a neurological disorder, that limits…
-
How can I Access Funding for Mobility Solutions?
Read More »: How can I Access Funding for Mobility Solutions?Accessing funding for mobility solutions involves navigating a combination of federal, state, and private resources. According to MedEquipped, there are several primary pathways available to help cover the costs of essential power mobility devices and custom wheelchairs: Insurance and Government…
-
How do I Get Complex Rehabilitation Technology Covered by Insurance?
Read More »: How do I Get Complex Rehabilitation Technology Covered by Insurance?To get complex rehabilitation technology (CRT) covered by insurance, you must follow a specific clinical and administrative process. The first step is to consult your physician for a written order and prescription that establishes medical necessity, such as for severe…