According to Medicare regulations, equipment may be reimbursed by Medicare if:

• Medicare is the primary insurance and there is no HMO involvement
• The beneficiary has Medicare part B coverage
• No similar equipment has been issued to the beneficiary (- Electric Wheelchairs and scooters are considered similar equipment).
• The beneficiary meets all criteria required by Medicare for specific equipment
• All required information has been provided on a Certificate of Medical Necessity or physician order prior to delivery of equipment
• Complete supporting documentation has been provided

MANUAL WHEELCHAIR
Medicare provides a manual wheelchair only to beneficiaries that would otherwise be bed or chair-bound. Beneficiaries who are able to manage their daily activities (i.e. move from bedroom to bathroom) without the use of a wheelchair and require the wheelchair only to make movement easier are NOT eligible.

Equipment for convenience (i.e. shopping, visits to the physician) is not reimbursed. Medicare requires documentation from the treating physician including a Certificate of Medicare Necessity which can be obtained from our customer service department, progress notes and/or an evaluation done by a physical therapist to support the information provided on the CMN. Documentation must be filled out prior to delivery of equipment.

POWER WHEELCHAIR
A power wheelchair is provided by Medicare to a beneficiary who would otherwise be bed or chair-confined and is incapable of using a manual wheelchair due to a medical condition which does not allow use of upper extremities. General weakness or convenience is not recognized by Medicare as criteria for a power wheelchair. A Certificate of Medical Necessity must be filled out by the treating physician and the information must be supported by progress notes and/or an evaluation performed by a physical therapist. Documentation must be filled out prior to delivery.

SCOOTER
A scooter is often used primarily for outdoor use and therefore requires extensive evidence from the specialist in physical medicine who is treating the patient and physical therapist that the scooter is to be used by a patient who cannot manage to bear weight for more then two steps without the use of the power operated vehicle. He must be unable to operate a manual wheelchair due to a medical condition affecting his arms or hands. He must be capable of safely operating the controls for the scooter and have adequate trunk control to be able to transfer safely from bed to scooter and to remain safely seated for long periods. A scooter provided primarily to make movement easier for the patient in his home, his being capable of moving about without the use of the scooter, or for outdoor activities such as shopping or visits to the physician, will be denied.

LIFT CHAIR
Medicare will provide only the mechanism of the lift chair. The furniture is the responsibility of the customer. The mechanism is reimbursable only if the beneficiary cannot attain a standing position even using the arms of a standard chair but, once standing, is capable of walking. Therefore, no beneficiary is eligible for both a lift chair and a wheelchair. A Certificate of Medical Necessity supported by further information is necessary. Documentation must be filled out prior to delivery.

WALKER
A walker will be provided by Medicare if the beneficiary has difficulty walking and cannot manage with a cane. Rollators are only reimbursed under very strict guidelines.