Yes, in order to be approved for Medicare reimbursement, specific criteria must be met. Medicare coverage criteria vary from product to product. Please see a brief overview below of current Medicare coverage guidelines:
- Manual wheelchairs
- Must be medically necessary as determined by Medicare and must be ordered by a physician.
- Power wheelchairs and scooters
- Must be medically necessary as determined by Medicare and must be ordered by a physician.
- Not covered if only needed or used outside of the home
- Not covered if a cane, walker or manual wheelchair will provide the necessary functional mobility
- Ambulatory aids (wheelchairs, walkers and canes)
- Must be medically necessary as determined by Medicare and must be ordered by a physician.
- Medicare will cover one ambulatory item every five years
- Hospital beds
- Must be medically necessary as determined by Medicare and must be ordered by a physician.
- Will cover semi-electric beds only
- Patient lifts
- Must be medically necessary as determined by Medicare and must be ordered by a physician.
- Only covers standard hydraulic-manual lift and sling
- Will not cover power or standing lifts
- Oxygen concentrators, CPAPs and nebulizers
- Must be medically necessary as determined by Medicare and must be ordered by a physician.
- Medicare will not cover a portable oxygen concentrator if they’ve already provided coverage for a home oxygen concentrator
- Commode chairs
- Covered if consumer is confined to bed or room
Home Health Medical suggests that you always contact Medicare or your insurance company directly for your individual eligibility requirements. The information above is only a guideline and does not guarantee payment.
If we can answer any additional questions or be of any assistance, feel free to contact our customer service representatives by phone at 317-621-HOME (4663) or toll-free at 877-621-4660 or e-mail us at homehealthmedical@eCommunity.com
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