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Medicare and power wheelchairs

By Jennie L. Phipps · Bankrate.com
Sunday, January 23, 2011
Posted: 10 am ET

Calculating the cost of health care is an important part of retirement planning. If you think that's easy, you haven't looked at Medicare regulations recently.

Many people living in retirement love their motorized wheelchairs because they provide so much freedom of movement, but since Jan. 1, getting a new electric-powered wheelchair has been a lot more difficult.

Previously, users of these wheelchairs got them free of charge; after they paid Medicare a small copay, they owned them outright. But beginning this month, Medicare requires equipment providers to essentially rent the wheelchairs to patients over a 13-month period. At the end of that time, if a patient still meets the requirements for needing and using the chair, he can keep the equipment with Medicare paying most of the maintenance costs. But if sometime during that 13-month period, the Medicare recipient is confined to a nursing home or moves in with a relative or otherwise switches residences, he will probably lose the chair because the provider is required to repossess it. If the chair is repossessed, the user must reapply -- an arduous process -- to get another chair

The American Association for Homecare argues that these new Medicare rules defy common sense and make it difficult for suppliers to offer power wheelchairs at Medicare-approved rates. The chairs have to be especially modified to meet the needs of an individual user, so the idea that they can be repossessed and then reused by somebody else is very impractical.

Because suppliers are fearful that spreading the payments over 13 months will mean that they won't be paid the entire price of the chair, some are modifying their payment policies. They are requiring Medicare recipients to pay upfront for the chairs and be reimbursed themselves over 13 months. While this might not be a problem for some affluent Medicare recipients, it is a huge burden for average people because the chairs cost as much as $6,000.

If you believe this Medicare regulation should be repealed, let your congressman or congresswoman know what you think.

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9 Comments
oconnorlori
February 25, 2011 at 4:32 pm

I own a DME company.
JS-It is illegal to solicit a patient per the govt. If you see this, you should report them.
Pattie-Your right, noone should judge the disabled. Every minute there are more people that become disabled, than die in this country.
Brad-Your right, renting in the long run cost Medicare more.
End the Ponzi Scheme-You live on a different planet and have no clue that every day we have 8,000+ new baby boomers, that's alot of people in need of equipment...eventually
Any questions?

JS
February 23, 2011 at 11:04 pm

Let me say, as a future doctor, that the powered wheelchair companies run a lucrative scam that aggressively recruits patients many of which have little need for a power wheelchair. We have all seen the commercials advertising free powered wheelchairs for just about everyone who has medicare. Well, I have seen these companies contact many of my medicare patients out of the blue saying they qualify for a chair without even knowing their general health or medical diagnoses. Who do you think pays for that? Many of the patients would suffice with a walker or even a cane. Further, the patients who continue to actually use their legs and struggle each day will find themselves remaining stable if not improving in their general condition while those who let a machine do everything for them will continue to get more de-conditioned. Few patients need these objects and they should be difficult to get and only on doctor's orders.

Tom Johnson
February 22, 2011 at 11:58 am

This is just a "taste" of things to come for seniors under the republican's plan to "balance the budget"! Seniors argue and fight over things, such as these vital (in MOST cases) motorized wheel chairs! Meanwhile, the very wealthy get very generous tax breaks; we blow $10 BILLION dollars a MONTH on 2 useless, unwinable wars. If these huge tax breaks were repealed for the top 1-2% of the very wealthy, if a lot of corporations REALLY paid taxes; and if we stop losing lives, and borrowing monies to pay the $10 BILLION per MONTH to fund these 2 worthless, unnecessay wars, then things like furnishing powered wheel chairs for the folks who REALLY need them would NOT be an issue!

Mary
February 08, 2011 at 10:47 pm

I can assure you that it is not a simple matter to get approved for Medicare or Medicaid to pay for a power wheelchair. The current requirement is that you need the chair to get around your home. It makes no sense whatsoever to me to repossess a wheelchair because someone moves in with a relative or into a nursing home. That person STILL needs the chair. The number of people who need such chairs permanently is far greater than those who only need it temporarily -- the only true justification for renting rather than purchase. The person who died 6 hours after receiving the chair is a statistical anomaly.

Missourian
February 04, 2011 at 9:04 am

A power chair with tilt capabilities and power extending leg rests can cost more than $45,000. I work at a non-profit that accepts chair donations. Within the past year, I've accepted three chairs with invoices that total more than $100,000. One chair had 6 hours use before the patient died--that's $7,600 per hour.

Pattie
January 29, 2011 at 2:43 am

Your chair is custom fitted, in that they chose the right width seat, the right type of chair, the right power of chair, the right type of seat, the right type of foot or let rests, etc. It is not custom fabricated, but it is custom assembled for you. I know this, I have a chair.

The seat portion separates from the base on certain makes and models of chairs, but certainly not all chairs. For most of us, we have to modify our homes, and have modified vehicles to transport these things. Without them we would be home bound and unable to have any independence.

We cannot just order these things willy-nilly. In order for any insurance to pay for them we must be evealuated by their representative,and have a physician's order to get them. Sure, if you are financially comfortable, you could probably pay cash for one, but more often than not, a person must rely on insurance, medicare, medicaid, whatever to pay for them. There is a great deal of regulation and red tape that is required to get them if you rely on insurance.

Brad makes a valid point. It cost more to rent an item, than it does to buy it outright. Chances are whether you need a CPAP, a nebulizer, an oxygen concensor, or a wheelchair, it is not a temporary need. The supplier will charge a monthly rate, and at the end of the agreement period, they will have charged as much or more than it would cost to buy it to begin with.

One who has never had to depend on alternate means of mobility or have to depend on Medicare or Medicaid to provide their health care needs should not comment on something they know little about. How dare you judge on something you have not experienced or had to deal with on your own.

When someone becomes disabled, they lose their income, often lose their home, vehicle, sense of pride,some their marriage, and become dependant on others for help. And then for someone to sit in an office and determine that the way to reduce health care costs is to take it away from those who need it the most, shame on you! Do not even start to say whether those who receive wheelchairs really need them or not unless you have "walked" a mile in my shoes.

Brad
January 24, 2011 at 10:29 am

Dealing with Government anything is arduous. Many have had trouble re-establishing benefits for medicare/medicade after turning down Social Security payments of $5 or $10 dollars a month- simply because of a "process" decision to tie the programs- thinking the government will save money doing things like renting medical equipment is often quite silly-- I had a rented "nebulizer" in my house for 4 days- then the one I bought online arrived- it was identical to the rental and cheaper than 4 days rent-- This obscession with ownership/ and re-use is essentially a boondoggle for the rental industry. --We as Citizens have been con'd -thinking that we are getting a "better" deal because we get the stuff "back" for "reuse" --in the age of disposable pricing- the real numbers / costs and benefits -- really could use some analysis --I doubt the system proposed "saves" much if any of our tax dollars-- and likly makes some lobbyist organizations members even more money.

End the Ponzi Scheme
January 24, 2011 at 9:36 am

How about at least trying to get facts right.

"The chairs have to be especially modified to meet the needs of an individual user, so the idea that they can be repossessed and then reused by somebody else is very impractical."

Bogus. They may assemble from a variety of sized parts, but I can guarantee that they are not custom fabricating anything. Repo a chair, sure, the base of most is where 90% of the expense is, batteries, electronics, motors. The seat portion and arm rests is window dressing, and the part that is customized. If you see how they are transported, the seat portion detaches from the base, and they collapse down. Ok, if we can't get the seat and arm bits to come apart, or were trashed by the previous owner, fine, discard that part, and reuse the base.

If I'm forced to pay for this stuff, I expect the expense to be justified, and not become a permanent benefit because at some point in the past it might have been necessary. Given the commercials for these things, I'm a bit suspect of the companies involved overplaying the need anyway.

We need more regulation cutting waste out of entitlements, not less, thanks for reminding me to give the congressman a pat on the back for this one.