Financing | Age In Place

[jbox title=”Medicare & Insurance Billing”]Mobility123 does not bill Medicare or Insurance companies and therefore does not accept Medicare or Insurance as payment. We suggest you contact them directly to find out eligibility requirements.[/jbox]

If you would like to take advantage of Medicare or Insurance coverage, consider this:

1. You can buy from us, at Mobility123, paying with cash or your credit card.
2. You will then need to submit to Medicare or your Insurance

  • Our invoice
  • Your Doctor’s prescription and diagnosis
  • Proof of Purchase
  • For Medicare beneficiaries a 1490 form

If you are approved, Medicare or your Insurance will reimburse you (Medicare pays up to 80% of the cost, your supplementary Insurance may cover the rest)

Reimbursement Criteria

In order to be approved for Medicare reimbursement, specific criteria must be met. These criteria vary from category to category. Below is an overview of the criteria used by Medicare to determine eligibility by category. The beneficiary may qualify for reimbursement for a power wheelchair or mobility scooter if the following general criteria are met:

Lift Chairs

Medicare only covers the seat-lift mechanism, but not the actual chair itself. The reimbursement amount is roughly $300 depending on the state in which the beneficiary is located if the coverage criteria are met.

A lift chair is considered medically necessary if the following criteria are met:

  • The patient must have severe arthritis of the hip or knee, or have a severe neuromuscular disease.
  • The seat lift mechanism must be a part of the physician’s course of treatment and be prescribed to effect improvement, or arrest or retard deterioration in the patient’s condition.
  • The patient must be completely incapable of standing up from a regular armchair or any chair in their home.
  • Once standing, the patient must have the ability to walk.
  • By Medicare standards, the fact that a patient has difficulty or is even incapable of getting up from a chair, particularly a low chair, is not sufficient justification for a seat lift mechanism. Almost all patients who are capable of ambulating can get out of an ordinary chair, if the seat height is appropriate and the chair has arms. Medicare requires that the physician ordering the seat lift mechanism must be the attending physician or a consulting physician for the disease or condition resulting in the need for a seat lift.

The beneficiary may qualify for reimbursement for a power wheelchair or mobility scooter if the following general criteria are met:

  • The beneficiary must have a mobility limitation which prevents them from performing one or more mobility related activities of daily living in the home, including toileting, eating, bathing, and grooming.
  • There can not be other conditions that limit the beneficiary from performing mobility-related activities of daily living at home, such as significant impairments of cognition or judgment and/or vision. This only applies if these other conditions can not be solved through other means, including caregiver support.
  • The beneficiary must demonstrate the capability and the willingness to consistently operate the device safely.
  • A cane, walker, or manual wheelchair will not provide the necessary functional mobility.
  • The beneficiary’s environment must allow for the use of a power wheelchair or scooter in all areas where the mobility related activities of daily living are customarily performed.
  • For a scooter, the beneficiary must have sufficient strength and postural stability to operate the scooter.
  • For a power wheelchair, the additional features provided by a power wheelchair must be required by the beneficiary in order to perform one or more mobility-related activities of daily living.