For your convenience we have provided an informal guide to what specific ailments are required for Medicare coverage to apply. These guidelines can give you a reasonable estimate as to whether you will be covered by Medicare. Medicare coverage is not guaranteed by this guide. As always, one of our associates would be glad to answer any questions or clarify any uncertainties you have. Contact information can be found here, or by clicking the "Contact Us" link on the left-hand side of the screen.
| Standard | Patient otherwise be bed or chair confined. |
| Lightweight | Same as above and patient is unable to self-propel in a standard weight wheelchair, but can self-propel in a lightweight wheelchair. |
| Hemi | Same as standard and requires a lower seat height due to short stature, or to enable the patient to place their feet on the ground for foot propulsion. (CVA) |
| High Strength Lightweight | Same as standard and patient requires a seat width, depth, or height that cannot be accomodated in a standard, lightweight, or hemi, and spends at least 2 hours per day in the wheelchair, and the length of need is at least three months. |
| Reclining | Same as standard and spends at least four hours per day in the wheelchair and has at least one of the following: quadriplegia, fixed hip or knee angle, trunk or leg casts or braces, excessive trunk extensor tone, patient needs to rest in the recumbent position two or more times per day, and transfer is difficult. |
| Power | Same as standard and patient is unable to operate any manual wheelchair and is capable of safely operating a power wheelchair. |
| Scooters | Same as power wheelchair and patient has adequate trunk stability to be able to ride the scooter and can safely transfer in and out of the scooter, and requires the scooter to get around inside the home. |
Canes, Walkers, Crutches |
Patient has impaired ambulation. |
Heavy Duty Walker |
Patient is unable to use standard walker due to obesity, severe neurologic disorders, or restricted use of one hand. |
Bedside Commode |
Patient is incapable of using regular toilet facilities. |
Drop-arm |
When needed to facilitate transfers, or due to body size (extra width). |
|
Not covered by Medicare. Some coverage by Medicaid. |
Seat Lift Chair |
Only seat lift mechanism covered. Patient must have severe arthritis of the hip or knee, or have severe neuromuscular disease; and be incapable of standing up from any chair in the home; and be able to ambulate once standing. |
Patient Lift |
Patient cannot transfer from bed without the help of more than one person. |
| Manual | One of the following must be met: |
| Variable Height | Same as manual and patient requires a different bed height to permit transfers. |
| Semi-electric | Same as manual and patient requires frequent and/or immediate need for a change in body position. |
| Fully-electric | Not covered by Medicare, but occasionally covered by Medicaid for patients that need to vary the height of the bed to facilitate transfer from bed to chair. |
| Trapeze Bar | Patient requires the trapeze to sit up due to respiratory condition, to change body position for other medical reasons, or to get in and out of bed. |