Does Insurance Cover Electric Wheelchairs?

Are you considering purchasing a power wheelchair but are asking yourself “Does insurance pay for power wheelchairs?” you’re at the right place. In this blog post I’ll explain what the process is for buying an electric wheelchair with insurance by going over the pros and cons. Like most things, the tips and information in this blog post may not apply to certain insurance policies and coverage so its best that you contact your insurance provider to get exact answers to your questions about your specific policy as there are thousands of insurance companies (click here to see just a few of them) and policy types available with a variety of options. In this blog post we’ll cover what it’s like using insurance for most policies (i.e. Humana, Bluecross, Medicare/Medicaid etc).

In a Nutshell, The Answer is Yes… But, Consider The Facts.

getting insurance to pay for my power wheelchair
Insurance companies will offer coverage for powered mobility but the fact of the matter is, the process is generally very elongated (can take up to 9 months) because of the enourmous amount of paperwork and doctor visits needed to get approved. After getting approved, you’re also going to be limited to only being able to purchase a mobility product which is considered to be sufficient at most, meaning you won’t be able to buy that fancy model with all the extra bells and whistles you wanted. Insurance companies are in business to make money for the most part and if you’re expecting the process of obtaining a power chair through your insurance to be painless, you’re likely in for an unpleasant surprise. Get ready to spend at least 3 months of going to the doctor and getting paper work filled out before you’re even approved. Once you do get approved, you’ll still have to buy the unit outright before getting reimbursed by the insurer in most cases which also takes another 2 to 3 months on average.

With that being said, let’s get into the good stuff… Let’s learn a little bit about each of the most common providers and what the process is like for getting coverage on a electric wheelchair.

Does Bluecross Blueshield Cover Power Wheelchairs?

will bluecross blueshield cover a power wheelchairAs it turns out Bluecross Blueshield does cover power wheelchair purchases under certain circumstances which are simliar to what most insurance companies require. The policy holder must see a doctor and the doctor must provide documentation indicating that the patient requires a powered mobility product in order to carry out day to day functions, has the necessary skills needed to operate a powered mobility product, expected to have a long term disability (longer than 6 months) and that the patient is going to need the mobility product for a reasonable period of time (i.e. don’t expect to get coverage for a rental if you’re going to Disney for the weekend). If you’re physically unable to use your upper body to perform day-to-day activities and you meet all requirements you can get reimbursed after you buy a power chair.

If time is a factor, for example if you’re trying to get your power wheelchair before having to leave town for an important event or if you have to travel for business then you may not want to seek coverage through BCBS or any insurer for that matter. It can take months for the paper work to go through needed for you to become approved and they won’t cover anything more than the most basic models available (the cheapest ones usually don’t last long either, you get what you pay for).

Will Medicare or Medicaid Pay For My Power Wheelchair?

will medicaid pay for my electric wheelchair
If you’re receiving coverage by medicare/Medicaid, you can get coverage for a power wheelchair however, there are a few points to consider. First, you must contact your doctor and obtain a note or prescription from your doctor explaining that you need a wheelchair to get around the house. The doctors visit must take place within 45 days of the time that you place your order from a dealer that is contracted by Medicare or Medicaid in order to receive coverage.

Downfalls to Using BlueCross to Buy a Power Chair

Like all insurance providers, BCBS doesn’t want to cover anyone who wants a power wheelchair as a convenience item, or to supplement the use of a manual wheelchair when your arms are sore from traveling long distances. It has to be an absolutely necessity not an luxury item primarily used for convenience. I managed to find a resource page from a BCBS agency online which lays out in technical terms what the steps are to get Bluecross coverage for an electric wheelchair. For those of you looking to find out how you can coverage for your next purchase, I encourage you to click here.

What Are The Downfalls To Buying With Medicare/Medicaid?

Aside from having to pay to see your doctor first, there is another big issue with getting Medicare to cover your electric wheelchair and that is the fact that you can only get coverage for the most basic models AND you have to fill out a lot of paper work which also requires approval on many levels. The entire process can take a very long time. Additionally, if you want a wheelchair to go to the park or because you travel a lot, forget about it, Medicare only covers purchases if the doc says you absolutely need it to move around in your HOME ONLY.

can_I_buy_a_power_wheelchair_with_medicare

As noted above directly from the Medicare site where the tip was taken, wheelchairs for leisure activities such as heavy duty power wheelchairs are not covered by medicare as they are not considered to be a necessity. It’s also worthy to note that if you are planning on obtaining a higher-end power wheelchair that is expensive because of the features it offers, you may not be covered either depending on if you have Medicare Advantage or not. To read the steps needed to obtain a power wheelchair or even a manual wheelchair visit the the official Medicare web page on the matter by clicking here.

What Are The Pro’s When Buying a Power Wheelchair Through Medicare?

Unfortunately, there aren’t many advantages to buying with Medicare’s coverage unless you’re on a very limited budget and want to only obtain the most basic type of unit. Additionally, providers that accept medicare are usually vetted by the insurance company to prevent customers from dealing with scam companies or fly by night organizations. Typically contracted HME / DME re-sellers are approved and undergo a rigorous application process.

What Are The Other Options For Someone Who is Ready to Buy Power Wheelchairs?

If you’re not so sure you’re up for waiting up to 6 months and filling out mountains of paper work, seeing your doctor and jumping through flaming hoops then you may want to consider financing your unit. Many private lenders and even the retailers that sell power wheelchairs online often offer hassle free financing with low interest rates allowing you to get that new electric wheelchair that you’ve been keeping an eye on. If you’re able to, there are many power wheelchair stores online like ours that offer the best prices and free shipping. To view a list of all the best power wheelchair brands and models that we offer, simply click on our menu at the top of the page under “Power Wheelchairs” and select your category to begin shopping.