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.
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