In a recent Senior Care Corner Radio Show, we reported a news story about a durable medical equipment (sometimes referred to as DME) provider being fined for fraudulent Medicare claims for power scooters. While many who this provider gave no- or low-cost scooters paid for by Medicare that were not deemed eligible, there are many seniors who would benefit from using a scooter or other durable medical devices.
Medicare does cover the cost of medically necessary durable medical equipment such as power chair scooters and wheelchairs as well as many other items seniors need to maintain their functional abilities.
What Will Medicare Cover and How Much Will Senior’s Pay?
Medicare Part B covers durable medical equipment, including wheelchairs, scooters, walkers and other items prescribed by a doctor for use in your senior’s home.
This equipment may be purchased outright or rented. It must come from a Medicare approved provider prescribed by a Medicare approved physician. Your senior is responsible for paying 20% of the Medicare approved amount.
If your senior’s DME provider does not accept Medicare assignment, the provider can charge any amount and your senior will be responsible for payment. In some cases, your senior may be asked to pay the full bill upfront at the time of receipt of the DME. It will be your decision to accept that arrangement or find another provider.
Some Items Medicare Part B Covers
- Blood sugar monitoring devices and diabetic test strips
- Canes (excluding white canes for the blind)
- Home oxygen and supplies, nebulizers, suction pumps, CPAP machines/supplies
- Hospital beds and air-fluidized beds
- Infusion pump, enteral nutrients/supplies/equipment
- Lifts (for transfers)
- Traction equipment
- Walkers, wheelchairs, power chair scooters
- Repair and replacement parts for required durable medical equipment
Items Not Covered by Medicare Part A/B:
- Dentures, routine dental care
- Eye care
- Hearing aids and exams
- Routine foot care
- Cosmetic surgery
- Long term care or custodial services
Medicare is an excellent source of medical coverage for our aging seniors. It is important that we are knowledgeable about the services and benefits that are available so that your senior gets their needs met and takes advantage of all the services for which they are eligible.
Caregivers should also know that there is some cost to durable medical equipment and other services under the Medicare program and these expenses will need to be taken into account when planning for aging care. There are secondary insurance policies and supplements that can help to offset these out of pocket expenses, if needed, but you and your senior must opt to enroll in these additional policies.
You can find more information at medicare.gov to help your seniors stay as independent, safe and functional as possible!