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
-
What is the Difference between Group 2 and Group 3 Heavy Duty Chairs?
Read More »: What is the Difference between Group 2 and Group 3 Heavy Duty Chairs?The primary differences between Group 2 and Group 3 heavy duty power wheelchairs involve their weight capacities, intended environments, and specific frame features. Based on RESNA definitions, the key distinctions include: Related FAQs
-
Does Medicare Part B Cover a Power Wheelchair with a 450 Lbs Weight Capacity?
Read More »: Does Medicare Part B Cover a Power Wheelchair with a 450 Lbs Weight Capacity?Yes, Medicare Part B does cover heavy-duty power wheelchairs with a 450 lbs weight capacity, provided specific medical necessity requirements are met. Under Medicare guidelines, a wheelchair with a 450 lbs capacity typically falls under the K0823 or K0824 HCPCS…
-
What Medical Documentation is Needed for Hcpcs Code K0823?
Read More »: What Medical Documentation is Needed for Hcpcs Code K0823?To qualify for a heavy-duty power wheelchair under HCPCS code K0823, Medicare requires specific medical documentation to prove medical necessity for use within the home. The following core documents must be gathered and submitted: Related FAQs
-
How do I Qualify for a Medicare-covered Heavy Duty Power Wheelchair?
Read More »: How do I Qualify for a Medicare-covered Heavy Duty Power Wheelchair?To qualify for a Medicare-covered heavy duty power wheelchair (specifically under HCPCS code K0823), you must meet several clinical and documentation requirements. Medicare classifies these as durable medical equipment and typically covers them under Part B when medical necessity is…
-
How do I Get a Custom Motorized Wheelchair Fitted?
Read More »: How do I Get a Custom Motorized Wheelchair Fitted?To get a custom motorized wheelchair fitted, you must go through a specialized clinical process involving certified professionals and detailed evaluations. At MedEquipped, the process typically follows these steps: Related FAQs