Nobody grows up obsessed with the idea of getting a mobility scooter or a wheelchair. They are not on anyone’s wish list unless your physical mobility is limited. While these means of transportation offer disabled people a new sense of freedom, they also bring some new and unexpected realities to life.
This blog is primarily about how to select a mobility scooter and how to determine if Medicare will pay for it. At some future date I might focus on other issues important to the disabled.
You will likely find that my emphasis is on scooters and that’s only because they the most common and least expensive way to get from one place to another if walking is not an option. Also, I am a mobility scooter user. We may address motorized wheelchairs specifically later. There are, though, some commonalities both share. One thing is certain. Your life is in for some big changes once you accept the keys to your new ride.
Scooter or wheelchair? That’s probably not a decision you will have to make, your physical condition may dictate what will work best for you, Disabled World offers this explanation. (http://tinyurl.com/b4gxgl)
Issues to Consider when Buying a Mobility Vehicle:
- Electric wheelchairs tend to be far more expensive than mobility scooters
- If you need to transport your personal mobility vehicle, a compact mobility scooter can be folded up to fit in a trunk or a back seat. Alternately, you can carry them behind a car with a trailer. Most electric wheelchairs do not fold and are too heavy for a simple trailer.
- If you have a wheelchair-modified van, it is easier and safer to tie down an electric wheelchair than a mobility scooter
- An electric medical scooter is steered with bicycle-like handlebars, whereas electric wheelchairs use a joystick. If you have issues with upper body mobility, a wheelchair might be easier to control.
- If you have posture issues, a wheelchair usually offers more features and support to help you, including motorized stand, tilt, and recline options.
- If you need to stay in your mobility aid for most of the day, a wheelchair is usually more comfortable.
The right choice of a personal mobility vehicle depends on how you are planning to use it.
- Are tight corners an issue?
- Would you like to fully enjoy the great outdoors, or are you more interested in shopping?
- Will you be running local errands, using public transportation, or using your own vehicle to move your personal mobility vehicle?
Once you answer these questions, you will be able to make the right choice for your specific situation.
I am the owner of two mobility scooters because I have COPD and can’t walk very far. One of the scooters is for outside the home and the other is for venues that offer flat, even surfaces upon which I can ride. Both of my scooters were paid for privately, no government funds were applied for or offered. If you want every minute detail about the process of acquiring mobility vehicles go to https://www.medicare.gov/coverage/manual-wheelchairs-and-power-mobility-devices.html If a summary will satisfy you read on.
Let’s start with the most common question. “Will Medicare pay for my wheelchair or mobility scooter?” That single question is the cause of a lot of confusion, because the answer is, “Maybe.”
There are many suppliers who will tell you that Medicare will pay and you may even hear it from trusted friends. Here’s the truth. Medicare will pay up to 80% of the cost of an “approved” scooter or wheelchair if the supplier accepts Medicare assignment. That means they have to agree in writing that they will accept what Medicare will pay and you can be billed for no more than 20 percent of the total. If the supplier does not accept Medicare assignment Medicare will still pay the standard amount, but the supplier can send you a bill for any amount they choose.
So, back to the answer. For Medicare to pay for a manual (unpowered) wheelchair, a senior must have a condition which prevents them from moving around in their home as they go about daily living. Their disability cannot be resolved through the use of a cane or walker and the wheelchair cannot be necessary only for use outside the home.
For Medicare to pay for an electric or powered wheelchair or scooter the individual must have the same needs as for a manual wheelchair but they must prove they do not have the physical strength to operate it. In addition they must demonstrate they have the ability to control the powered device without hurting themselves or those around them. Key point
here. You have to show that you need it to get around in your home and that your home is barrier free.
In either case, getting Medicare to pay is not an easy task. A written order from a doctor is necessary which must state the medical reason for the need and the type of wheelchair which is required. Be very careful. Medicare fraud is rampant and usually committed by suppliers or others who sell the goods, services, medicine and medical equipment that seniors need.
Recently I met a man my age who had a scooter identical to mine. I asked how he liked it and he told me that not only was it a great scooter but that Medicare had paid for it. Now I know better than that so I asked how that worked and he explained that with the help of his scooter supplier he found a physician who provided the medical certification he needed. Beware – if any supplier has a list of Doctors you can see who will approve your purchase it is likely you will get one fraudulently.
The Medicare website says this about getting started on the road to acquiring a scooter or wheelchair. http://www.medicareinteractive.org/page2.php?topic=counselor&page=script&script_id=189
“Before you get your wheelchair or scooter, you must have an office visit with your doctor. The visit should take place no more than 45 days before the DME (Durable Medical Equipment) order and should deal with the medical reasons you need the wheelchair or scooter.
Your provider must sign an order or fill out a prescription or certificate that states that you need the power wheelchair or scooter to function in the home. The order must state:
Your health makes it very hard to move around in your home even with the help of a walker or cane;
- You have significant problems in your home performing activities of daily living such as getting to the toilet, getting in and out of a bed or a chair, bathing, and dressing;
- If you need a power wheelchair, you cannot use a manual wheelchair or scooter, but you can safely use a power wheelchair and
- The required office visit with your doctor took place.
The equipment must be necessary for you in the home but you can also use it outside the home. You can get only one piece of equipment to address your at-home mobility problem. Your doctor or other provider will determine what equipment you need based on your condition, what equipment can be used in your home, and what equipment you are able to use.”
Now some other scooter issues.
As we mentioned the scooter has to first be approved for use in your home. If that has been done then you must consider where else you might use it. Medicare might give you some leeway in your choice of vehicles, but not much and if they do and you choose one with all the bells and whistles you could wind up with a hefty bill.
Outside the home, here’s what you should consider.
- How will you transport it? Assuming you might want to pack it into the back of the mini-van how will you do that? Your scooter will have to be transportable, that means lightweight and easy to disassemble and assemble unless you can afford a power ramp on the back of your vehicle, one onto which you can drive so there’s no lifting or disassembling involved.
- How much clearance is there between the bottom of the scooter and the road below? My bigger scooter has a little over 5 inches. The new, smaller one has but 2.5. That means if you get into an area without curb cuts you will be unable to use sidewalks and take my word for it, the streets are no place for scooters or wheelchairs. They are much too slow and often invisible to drivers of cars and trucks. Smaller scooters with low clearance can get stopped by ruts, bumps and uneven surfaces very easily and if you are alone, what do you do?
- Lighting. Most scooters and wheelchairs don’t come with it. Buy a headlight and taillight anyway, you never know when you will be caught out after dark and a scooter or wheelchair without lights is an accident waiting to happen. Some mobility vehicles don’t even come with reflectors, buy a couple of those as well.
- Safety flag. You should also purchase a safety flag that stands about 4 or 5 feet high from the back of your vehicle. It will help both drivers and pedestrians see you coming and add some safety insurance.
- A basket. Most come with a basket, but if not get one. You will need somewhere to put your “Stuff.” You can even buy drink holders that snap on to your armrests.
- Because I drive my scooter to the supermarket about a mile away a couple of times a week I drive though areas where homes are being remodeled or built and where other construction work is done. I had several flat tires until I went to a local bicycle shop to have solid rubber tires installed. No more flats. Some will tell you that solid rubber tires offer a much bumpier ride, but the fact is that scooters and wheelchairs ride like skate boards anyway. Get the solid rubber. If you are a purist and insist on pneumatic tires, get a patch kit and a tire pump and keep it in the basket of your scooter because you will need it.
- Cane holder. If you use a cane you’ll need a holder. The maker of your vehicle probably has them as an accessory or they might even include one at no extra charge.
- Rear View Mirror. It may sound silly but consider this, you are driving and you need to know what’s in back of you as well as what’s ahead. Rear view mirrors will come in quite handy. You will realize how important they are when you back into someone for the first time.
- Batteries. How far will they take you, how long will they last and do they come with a charger?
- Capacity. How much weight will it safely transport?
- Test drive. Ask to take it somewhere out of the showroom…around the block, into a mall, somewhere where you can get the “feel” of the scooter.
Those are the basics. I know I have only scratched the surface, but perhaps you will find something useful here anyway. You can add to the list once you have become an experienced mobility vehicle driver – and – you will add to the list. I purposely did not get into Scooter/Wheelchair brands and suppliers. Just Google Mobility scooters/wheelchairs and you will get all the information you need. There are also several Internet forums you can join to chat with other users about their experiences.
Finally, this word. There have been admirable attempts at making the world more accessible, but they are too few and still too rare. In many buildings you will find stairways and no ramps. Disabled parking is often abused by those who don’t need it. Mobility carts in supermarkets and other businesses are wonderful, if you can get one. Again, too many people who don’t need them, ride them. Even the sidewalks can be problematic when cars parked in driveways overlap and block the sidewalk, forcing scooters and wheelchairs into the street. And, most importantly those of us who are disabled are simply not seen. I can’t tell you how many times people are looking over my head as they walk right into my scooter.
Elevators also present a problem. If I can get my scooter in all the way to the back of the elevator before anyone enters there is usually room for several more people and often they will stand back and allow me to do that. On other occasions, though, the crowd surges around me, packs the elevator and then as the door is closing they will look surprised when they see there is no room for me even though I was there first.
Anyone who has a mobility vehicle will have their own stories to tell. None of us want special treatment we only want to be noticed and considered. And, oh, there is one more item. Don’t be surprised when while on your scooter in the company of your significant other a clerk or salesperson will address them not you. For example it is not uncommon for a clerk who would like me to get up to look at something to say to my wife, “Can he walk?” She often says, “Yes, and he hears and talks, too.”
So, the next time you see a disabled person think for just a moment about what it must be like to be unable to walk very far if at all and how riding a scooter or wheelchair presents a whole new set of barriers. A little consideration goes a very long way.
I have written two other blogs on mobility vehicles here on Bob’s Newheart. You can find them by clicking on these links.
Bob Aronson of Bob’s Newheart is a 2007 heart transplant recipient, the founder of Facebook’s over 4,200 member Organ Transplant Initiative (OTI) and the author of most of these donation/transplantation blogs. You may comment in the space provided or email your thoughts to me at firstname.lastname@example.org. And – please spread the word about the immediate need for more organ donors. There is nothing you can do that is of greater importance. If you convince one person to be an organ and tissue donor you may save or positively affect over 60 lives. Some of those lives may be people you know and love. You can register to be a donor at http://www.donatelife.net. It only takes a few minutes. Then, when registered, tell your family about your decision so there is no confusion when the time comes.
Mobility Scooters and Chairs…Buyer Beware
By Bob Aronson
We’ve all seen the commercials from “The Scooter Store” and other like them that leave the impression that almost anyone can get one of these vehicles free. Well buyers should have factual information before making a decision.
First, there’s a huge difference between a scooter and a wheelchair and there’s a big difference between a powered and a manually operated chair and there’s an even bigger difference in the chairs and the manufacturers. Selecting such a vehicle takes time and patience. I know because I recently selected a scooter that my sister purchased for me. It took several days of internet research to sort them all out.
Let’s start with those claims about getting Medicare to provide you with a Buck Rogers type chair that will take you anywhere safely and in style. You can read the full report by clicking on this link but I’ll summarize it for you as well. http://tinyurl.com/7guvxx6
Medicare coverage for electric mobility scooters
Medicare Part B will cover most of the cost of electric mobility scooters, but only if your doctor determines that it is medically necessary. The scooter must also be used primarily for moving about your home and not as a “recreational” vehicle. You may have to pay up to 20 percent of the cost after meeting your Part B deductible.
Other requirements for Medicare coverage include:
· Your evaluation must be with a doctor or other qualified health provider
· The evaluation must be documented and say that you need a mobility aid for a medical condition (called a “Certificate of Medical Necessity)
· You must present the order or prescription to the Medicare-approved electric scooter supplier before Medicare can be billed
· You must be able to safely operate, and get on and get off of the scooter
· You must have good vision
· You must have a health condition that causes difficulty for you to move around in your home
Recent changes to Medicare coverage for mobility scooters
There have been several recent changes to Medicare coverage for “Durable Medical Equipment,” which includes medical supplies and electric mobility scooters. It’s important that you read and understand these changes.
In an effort to cut costs, Medicare began to implement what is called “competitive bidding” at the beginning of 2011. The program requires providers and suppliers of Durable Medical Equipment to submit competitive bids for their products in order to stay or become Medicare-approved. Under this new rule, you must use Medicare-approved suppliers, or Medicare will not pay for the item.
There’s a whole lot more you should know about Medicare coverage so if you decide to pursue that route, click on the link I provided. It’s all there.
If you choose to get an electric wheelchair and want Medicare to cover it,you will be pretty much restricted to what they will pay for. Certainly there are some things to look for that are critical and first among them is whether your home is wheelchair accessible. Wheelchair accessible refers to the capabilities of a building or structure to offer individuals that utilize a wheelchair or other mobility device, the ability to maneuver without interference. Will the chair fit through doorways? Are there ramps instead of stairs? Are the rooms big enough for the chair to turn around in (bathrooms in particular) This video will give you some idea of what it takes to make some homes wheelchair “Friendly.” http://tinyurl.com/o6eq4lh
If your residence is not accessible you have three choices. 1) you can remodel it to meet your needs. 2) you can move to a residence that is accessible 3) you abandon the idea of using a wheelchair. Should you choose to remodel your living quarters there may be some federal assistance available according to the Council for Disability Rights. http://www.disabilityrights.org/mod3.htm.
Should your home be accessible and should your physician prescribe a mobility vehicle for you there are several choices ranging from manually powered wheelchairs to power scooters but remember, they must be used in the home. For details see this link http://www.medicare.gov/Pubs/pdf/11046.pdf
Most doctors, health care providers, suppliers, and private companies who work with Medicare are honest. However, there are a few who aren’t. For example, some
suppliers of medical equipment try to cheat Medicare by offering expensive power
wheelchairs and scooters to people who don’t qualify for these items. Also, some
suppliers of medical equipment may call you without your permission, even though “cold calling” isn’t allowed. Medicare is trying harder than ever to find and prevent fraud and abuse by working more closely with health care providers, strengthening oversight, and reviewing claims data.
If you want to use a mobility vehicle outside of the home the expense is yours even though you have a legitimate disability powered vehicles are not covered by Medicare.
I have Chronic Obstructive Pulmonary Disease (COPD) simply put, my lungs don’t work very well and I run out of breath easily so that means I can’t walk very far without having to stop to rest. Despite that and despite my pulmonologists certification that I have the disease I do not qualify for a mobility vehicle for use outside the home even though it would allow me to do things I can’t normally do like take a walk with my wife (she walks I ride), walk the dogs, go ashore on a cruise or any of a number of things.
The major difference between scooters and wheelchairs is where they can be used and turning radius. Wheelchairs can turn on a dime, scooters cannot but scooters offer more flexibility like outdoor use, carrying capacity, clearance from the ground, speed, portability and some will even pull a small trailer.
According to “Disabled World” here’s the difference between an electric wheelchair and a scooter. http://www.disabled-world.com/assistivedevices/mobility/scooters/scooters-vs-wheelchairs.php.
An electric powered wheelchair for long-term use is a high-tech piece of equipment with a host of advanced features to vastly improve mobility.
An electric wheelchair usually has four to six wheels and is steered by a programmable joystick. Electric powered wheelchairs are highly maneuverable and can be used both indoors and on even terrain outside.
An electric wheelchair offers the widest array of seat movement options of any personal mobility vehicle. Many wheelchairs offer motorized stand, tilt, and recline functions which make them more comfortable to use for long periods of time. They also offer more support for people who have posture issues.
Powered wheelchairs are very heavy, which makes them durable and stabile, but which also makes them impossible to carry and limits their ability to be used with lifts. Powered wheelchairs generally do not fold, which means they cannot be easily transported in a standard car. Furthermore, their weight makes them too heavy for simple scooter lifts and trailers.
The tradeoff, however, is that electric wheelchairs offer four-point tie downs, which make them safer to use as a seat in a moving vehicle.
Electric power wheelchairs are the most expensive type of personal mobility vehicle; the models with advanced speed, power, and features rival or exceed automobiles for cost. Wheelchair prices can go up to around $15,000.
What Advantages and Disadvantages Does an Electric Medical Scooter Offer?
An electric mobility scooter is an excellent, low-cost way to be able to travel independently, both indoors and outdoors. Many people prefer a medical scooter over an electric wheelchair because they simply look cooler. There is a psychological advantage to not being confined in a wheelchair, and scooters offer a wide variety of styles, colors, and designs to make using a scooter more fun.
Mobility scooters can be broken down into three general types: the 3-wheel mobility scooter, the 4-wheel mobility scooter, and the compact mobility scooter. These three types of medical scooter cover a wide range of uses, from travel on rough terrain to navigation in tight areas such as store aisles.
A 3-wheel mobility scooter offers a tight turning radius and more room for long or stiff legs. A 4-wheel mobility scooter is more rugged and stabile, and can support weight of up to 500 pounds. A compact mobility scooter can be easily folded or disassembled for transportation in the trunk of a car.
A compact mobility scooter is also a good choice if the storage room in your home is limited. These medical scooters can be easily kept in an out-of-the-way corner or closet.
An electric mobility scooter is usually controlled with handlebars similar to those found on bicycles. They can reach speeds of up to 10 miles per hour, and some models can be used on roads, across fields, and up steep hills.
Another option for transporting a medical scooter is to use a simple trailer attached to the back of the car. With this kind of personal mobility vehicle, you do not have to buy a specially-equipped handicapped van to be able to travel in comfort.
A medical scooter is a cost-effective way to restore your mobility and independence. Even feature-packed models cost only a fraction of the price of an electric powered wheelchair. You can expect costs ranging from $1,000 to $5,000.
The scooter given to me by my sister and brother in law was one I selected after a lot of research. My criteria were as follows:
1. At least 5 inches of ground clearance so uneven pavement, curbs, knobby grassy areas and other uneven paths would not hang me up or cause damage.
2. Portability. It had to come apart in at least two pieces with no piece heavier than 50 lbs. It also had to be easy to assemble and disassemble with a minimum of lifting or bending.
3. Capacity. I weight about 180 and wanted a scooter that would carry twice my weight just as a safety factor. It also offers me the ability to carry some cargo like groceries or tools.
4. Lighting. Studies show that mobility vehicles with appropriate lighting are far less likely to be involved in an accident so mine has head and tail lights, brake lights, turn signals and hazard lights.
5. Speed. Most mobility vehicles are turtle slow like about 4 miles an hour. The one I bought will go 8. Obviously not speedy but fast enough.
6. Distance. Batteries ought to give you enough power to travel up to 20 miles. Some only go 5 or 6 and that diminishes as you go faster or up hills.
7. Transaxle. A good scooter should be able to get up and down city hills. A Transaxle acts like a transmission in a car and allows the vehicle to select the right gear for the grade
8. Ease of mounting and dismounting. The term speaks for itself.
9. Leg room. Again, the term speaks for itself
10.Cargo capacity. Mine comes with a rear mounted basket that will hold up to 3 bags of groceries.
11. Reverse gear. You don’t want to be up against a tree or curb and have to get off to lift and turn the vehicle. It must have a reverse gear.
12.Cane or crutch holder. Many mobility riders need canes or crutches when they dismount and go on by foot. Your vehicle should be able to accommodate this need.
13.Cup holder. You are going to carry a drink, where will you put it?
14.Rear view mirror. Just like a car, you need to be able to see what’s behind you.
15.Keyed ignition. If you need a key to start and run it, it is more difficult to steal it.
16.Comfortable, adjustable seating. It must be comfortable and adjustable for height and other needs.
17.Easy battery connectivity. Batteries should be easily removable and replaceable without connecting wires or using tools.
18.Battery charging. Your mobility vehicle should have the capacity to be charged by the car or truck’s electrical system instead of waiting to get home to plug it in.
19.Tires. The bigger the better.
20.Number of wheels. A four wheel scooter is more stable but a three wheel scooter is more maneuverable.
21.Warranty and repair. Make sure you get a good warranty and that your mobility vehicle is repairable nearby.
That’s my list of criteria, you may develop your own but I think you can see that selecting a mobility vehicle is more complicated than going to Wal-mart and picking the first one you see. Remember, too, that prices vary. They range from as little as $500 to well over $5,000 depending on what you are seeking.
In some cases, should you choose a heavy duty, non-portable scooter you may be faced with the added expense of adding a lift or carrying platform to your car or truck. Those items can also run into the thousands of dollars.
The point of all of this is, do your homework. Carefully determine just exactly why you want a scooter and what you will use it for. And always ask yourself this question, “Is this the scooter I want, or is it the one I need.” There could be a huge difference between the two.
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