Insurance for Scooters

I am new to needing a scooter but now I really need one badly. I drive a Toyota RAV4 and I will need something so light that I can lift up easily or a lift. My real question is how do I go about buying a scooter? Will insurance cover anything? I have Medicare & Medicaid. Really appreciate all answers.

Medicare will pay for one but you need a prescription from your physician.
They will only pay for one assistive device in five years
That means anything from a cane to a scooter or wheelchair so be very wise in what you request.

I have a compact electric wheelchair. Total weight with the batteries is 58 pounds. I love it. Quick n Mobile. It is great. If you have balance and strength, not a weightlifter, it is very manageable.

Here’s the official medicare position: does medicare or medicaid cover the cost of scooters - Google Search

Hi! If you have Medicare & Medicaid and you would like them to pay for it, the first step would be to get a prescription from your doctor stating you need a medical device. From there you can begin to work with either an occupational therapist or a physical therapist to understand what device would be best for you. You want the prescription to be very specific to what you need or Medicare will try to get around providing you what you need.

I recently got a new chair through a private insurance company, and once I had the prescription, a consultation from an OT/PT, and a decision on exactly what chair I needed, we submitted it to insurance for approval. This process took a very long time unfortunately. I continuing called to get status updates and hope to push things through. Once insurance approved, we were able to order the chair. Then it took ~2 months to receive the chair.

Its a long process - took 10 months from start to finish for me - but definitely worth it to not have to pay out of pocket for a custom power wheelchair. Let me know of any further Qs!

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Hi Emily, it’s Pinky :fairy:. This time I have a question about the chair ordering because I have not tried to use my insurance for my last two chairs because of the wait time issues and the fact the first time my insurance company only was willing to pay for a piece of crap chair.

However… now I have a Primary Care plan instead of regular Medicare and I want to get a new chair. Did you have any restrictions about what kind of chair you could pick? Brand, models, parts (wheels, shocks, cushions, etc…) I know they won’t buy me a top of the line Titanium model or anything else fancy, but I came across some documents that said the insurance company is only interested in making you mobile while in your home. Anything outside of that, they don’t consider they’re problem. (I know…I was shocked).

Now I know there are Medicaid and other State and local programs to help get a better chair if I was going to school or work; but unfortunately that’s not one of my options anymore, so thinking that the insurance route is my best option.

Thank you so much for your help with this and all your other posts! Your so FABULOUS with all your knowledge.

Pinky :fairy:

So I wanted a chair that has a manual base and then power assist from eFix placed on top of it, which is not a standard thing to do. I have had a similar chair over the past 10 years that worked well for me that I paid out of pocket for back then. I had the DR, OT, and PT all recommend that I NEED the exact same chair, that was the key.

I am an ambulatory wheelchair user and wanted something light enough that two people could easily lift and fairly small. I’m consistently by myself and on the go, and need something that can fit my lifestyle.

I worked closely with National Seating to ensure we were requesting every detail of what I needed to insurance. Things like I wanted cushions for the foot pedals, a particular seat, etc. After months, insurance came back and said I needed to use a manual wheelchair for 6 months before I could get a power wheelchair…LOL. I’ve used a power wheelchair since I was 4 years old, so this was comical.

I called the insurance company many times and we were able to get to where they agreed to pay 80% and I paid 20%. When the chair arrived, there were still a few things that we had to adjust but I was happy to finally have my new chair.

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Thank you Emily. :kissing_heart: I really appreciate you sharing that with me. Very glad to hear I am not the only one to have paid out-of-pocket for a chair to get the one we want. So many other chair users would ask me “how I got Medicare to pay for my Kuschall (which I hate) manual chair”, since its not a brand they would even pay for; let alone a specialized one. Even though I am on Medicare too, I had not realized till then how many people go through the long hellish battles with them to get the chairs they need. Then they would share with me how insane the system is when you want a specific chair with specific parts. :exploding_head:

I swear I am not a naive person; just a new wheelchair user in the last 7-8 years and have been “woke” to what our challenges truly are just to be able to function as much as we can. Speaking of, that was NUTS they wanted you have to use a manual chair for 6 months first after you had been using a power chair so long… sooooo crazy! Wish I could say that’s the craziest “chair-ordering” story I have heard, but I’ve been shared with the most insane tales of Medicare ordering nightmares that would make your eyes pop out of your head like an Looney Toons cartoon. :eyes:

I may have to hit you up for some tips about dealing with National Seating offline; that’s once of the vendors my OT wanted me to use before covid lockdown. That’s FABULOUS about knowing to have the DR, OT and PT all make sure to recommend the exact same chair. (Currently they all try to push off the chair ordering help to each other because they know how much work will be involved; especially getting an appt. with the chair fitter :woozy_face:.)

Ok, I am going to take all your advice and get this started before my other chair collapses in on itself. Especially if it takes that long. Thank you again for your help with this. It’s good to have chair friends like this so we can talk about this stuff, since so much of this world has no idea what we’re ever talking about…LOL.

Pinky :fairy:

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Yes, definitely is a process I would recommend getting started with sooner rather than later. And feel free to reach out to me regarding National Seating…I have some tips and tricks.