Medicare (Insurance) Requirement for Mobility Scooter

Will Medicare Pay for a Scooter?: Everything You Need to Know

Learn how to qualify for a Medicare-covered mobility scooter and the benefits it provides. Get the mobility assistance you need with Medicare.

Are you wondering if Medicare will cover the cost of a mobility scooter? You’ve come to the right place. In this guide, we’ll walk you through everything you need to know about qualifying for a Medicare-covered mobility scooter and the benefits it can provide.

What is a Medicare-covered mobility scooter?

A Medicare-covered mobility scooter is a device designed to assist individuals with mobility issues. These scooters can help individuals move around more easily and independently, improving their quality of life.

How do I qualify for a Medicare-covered mobility scooter?

To qualify for a Medicare-covered mobility scooter, you must meet certain eligibility requirements. These requirements typically include having a medical need for the scooter and obtaining a prescription from a healthcare provider.

What types of mobility scooters are covered by Medicare?

Medicare typically covers a range of mobility scooters, including standard and heavy-duty models. It’s important to consult with your healthcare provider to determine which type of scooter is best suited to your needs.

What are the benefits of having a Medicare-covered mobility scooter?

Having a Medicare-covered mobility scooter can provide numerous benefits, including increased independence, improved mobility, and enhanced quality of life. These scooters can help individuals navigate their daily activities with ease.

How do I apply for a Medicare-covered mobility scooter?

To apply for a Medicare-covered mobility scooter, you’ll need to follow a specific process outlined by Medicare. This process typically involves obtaining a prescription from a healthcare provider and submitting a claim for coverage.

It all starts with a face to face visit with the doctor or nurse practitioner. The visit must end with an 8 element script described below and the notes from the face to face with all of the required information. 

Remember the primary purpose of the face to face visit is to evaluate the need for Scooter (Insurance does not allow any forms for you to used). 

  • Doctor or Nurse Practitioner’s Notes from the Face to Face Visit Must Include:
    • Primary purpose of the doctor visit is: SCOOTER (POV) ( Insurance will NOT accept office visits for any other reason.
    • The Purpose of the Scooter is for MRADL’s (mobility related activities to daily living) in the home ONLY!  Use outside the home is NOT justification for the equipment.
    • The user’s physical mobility defined in a quantitative manner (i.e. do not use phrases like: “weak”, “limited”) A number scale is needed to define upper and lower extremity strength (i.e. upper body strength is 3/5). NOTE: If your patient’s upper extremity strength is 5/5, Insurance will only authorize a manual wheelchair.
    • Upper & Lower body mobility and strength must be addressed in the notes.
    • Justification for why the user cannot use the following equipment for mobility: cane, walker, walker with wheelchair, any type of manual wheelchair IN THE HOME.
    • The user can operate the tiller of the scooter.
    • The user is alert and oriented and is able to safely drive,
    • The user is able to Maintain postural stability and position while operating the equipment.
    • The user can safely transfer to and from the scooter.
    • The Doctor or Nurse Practitioner MUST physically or electronically sign and date each page of the notes.
    • Date of the Notes and the Date on the Script for the Face to Face Visit MUST Match
  • Once the Face to Face visit is complete, a Doctor or Nurse Practitioner must write a script with the following information:
    1. Name of Patient
    2. Write: “Scooter” as prescribed item
    3. Write : “Date of Face to Face Visit: XX/XX/XX”the word Face to Face must appear on the script
    4. Write: “Length of Need: 99” Meaning the length of need is for lifetime
    5. Diagnosis Codes pertaining to receiving a scooter
    6. Doctor’s or Nurse Practitioner’s Signature (no rubber stamps)
    7. The Signature has to be dated (Yes, there are two dates on the script)
    8. Doctor’s or Nurse Practitioner’s NPI number
Mobility Scooter Requirements for Insurance Coverage
Download a Guide of the Mobility Scooter Requirements
8-element-order-mobility-scooter
Download an Example of a 8 Element Script for a Mobility Scooter

This information is for educational purposes only. Contact your local DME dealer.