Medicare and wheelchairs, experience?

[DawnM]

Have any of you gotten medicare to cover a transport type wheelchair for an elderly who has trouble walking?

I will just get one if they usually don't cover it.

My dad used to take 6" or so steps/shuffles and still get by.   He is now down to 1" shuffles and yesterday it took him a full 25 min. to walk the length of a building to the courthouse (he has to get a background check to move in with us because we have a foster child.).   We were 10 min. early to the appointment but with the 25 minute walk we were late and he was completely winded by the end of it.   

I told him yesterday we are getting a wheelchair for days like this, and he didn't argue with me, which for him is a huge deal!  😜   

thanks

[Mrs Tiggywinkle]

So yes, Medicare will often cover wheelchair vans for this like medical appointments, return from Hospital, etc.  however, the medical wheelchair van people won’t usually push the wheelchair.  They’ll drive the person to the person to the destination and will let them off the van in the lift, but won’t always push the person into the doctor’s office for example.

 

[Tap]

Yes, Medicare can help you. But honestly, I would look on Facebook Marketplace, Craigslist etc and see if you can buy one used. It would likely be faster and less hassle. A wheelchair can be so  liberating for the person and family! 

Using Google, I would locate places in your area that will bill wheelchairs to Medicare. If you want Medicare to pay for one, message his PCP to ask them to write you a prescription and go from there. 

When you get one, make sure it is a style that fits in your car. Some smaller cars have trunks that aren't wheelchair friendly. Medicare has a max amount they will pay. Sometimes you can pay a extra and get something that is lighter/smaller framed (unless the patient is a larger person) to make them easier to maneuver. Wheelchairs can be a bit unwieldy to wrangle in and out of cars. Look for Youtube videos to get suggestions on how to do it without injuring yourself. There are lots of tricks that seem obvious once you learn them, but are elusive when you are first trying to figure it all out. 

Since he is mobile, remember that it can be easier to have him stand sometimes as you figure out how to go in an out of places. Curbs, door frames, threshold, cracks in sidewalks, uneven ground, hills, going in and out of doorways, finding a table to sit at that works with the chair in a restaurant etc are hurdles that wheelchair users face everyday. I wish our world was easier for wheelchairs users to navigate! 😞 

[Faith-manor]

We found for my grandma, that the max Medicare would pay did not provide for a wheelchair that actually met her needs and was comfortable. She was going to spend a LOT of time in it so comfort was a very big deal. My sister found a used one that met the need well, and it was purchased with her private funds.

Easy to collapse for transporting is a big deal. Definitely keep that in mind.

The times in which a family rep was not with her, the driver of the handicap van called the reception desk of the facility, and someone came out to wheel her in because she could not do it herself. I have no idea if every facility does this or not. That is just how it worked in her case. When she needed a hospital bed, Medicare did pay for that as well, but only for the one with the nasty, hard as a rock, cheap mattress. We had Medicare buy the bed, but then we used her funds to buy a different mattress that fit it. I think she would have had bed sores and a lot of aches and pains if we had not done that.

[PeterPan]

We're going through the walking thing with my dad. Getting the wheelchair is easy (amazon, medicare, whatever). But what you might do also is check about therapy for him to improve the walking. He might have some other options, like walking with a walker, and they might be able to get those steps longer by getting them back. Also, the doctor's office should have had a wheelchair. So you could park, run in and get the chair, and run out with it to get him. 

I was surprised to realize the assisted living would rather their people go on the shuttle with a walker (easier to fold/store) and then let the driver run and get a scooter or wheelchair. That's easier for them than dealing with big equipment.

If he can go faster with a walker and with some therapy, that might be safest. My dad went down *very quickly* once he hit this stage and sat down. And that affects how they shower, bathroom, everything.

[J-rap]

We've had insurance and Medicare cover a wheelchair pretty easily.  I've also donated ones to second-hand stores when we didn't need them anymore, so you can look there as well.  

Does he have a walker now?  There are some with seats where he can stop and rest if he needs to.  I will say that once you have a wheelchair, unless you're particularly motivated, you probably will not ever improve enough to NOT need a wheelchair again.  But of course there's a time when that's completely okay.

 

[Carol in Cal.]

The last I heard (maybe 5 years ago) Medicare would cover a wheelchair or a walker, and since walkers are much cheaper, it was considered better to use the benefit for the wheelchair and buy the walker yourself.  Either way, I think it had to be prescribed.

Both show up on the secondary market a lot.

[DawnM]

1 hour ago, Tap said:

Yes, Medicare can help you. But honestly, I would look on Facebook Marketplace, Craigslist etc and see if you can buy one used. It would likely be faster and less hassle. A wheelchair can be so  liberating for the person and family! 

Using Google, I would locate places in your area that will bill wheelchairs to Medicare. If you want Medicare to pay for one, message his PCP to ask them to write you a prescription and go from there. 

When you get one, make sure it is a style that fits in your car. Some smaller cars have trunks that aren't wheelchair friendly. Medicare has a max amount they will pay. Sometimes you can pay a extra and get something that is lighter/smaller framed (unless the patient is a larger person) to make them easier to maneuver. Wheelchairs can be a bit unwieldy to wrangle in and out of cars. Look for Youtube videos to get suggestions on how to do it without injuring yourself. There are lots of tricks that seem obvious once you learn them, but are elusive when you are first trying to figure it all out. 

Since he is mobile, remember that it can be easier to have him stand sometimes as you figure out how to go in an out of places. Curbs, door frames, threshold, cracks in sidewalks, uneven ground, hills, going in and out of doorways, finding a table to sit at that works with the chair in a restaurant etc are hurdles that wheelchair users face everyday. I wish our world was easier for wheelchairs users to navigate! 😞 

 

I have already looked at every used location......none of them are cheap.   People want $100 for a $120 Amazon wheelchair for example.

 

The other stuff, yes, I am aware.  thanks.

[DawnM]

1 hour ago, Mrs Tiggywinkle said:

So yes, Medicare will often cover wheelchair vans for this like medical appointments, return from Hospital, etc.  however, the medical wheelchair van people won’t usually push the wheelchair.  They’ll drive the person to the person to the destination and will let them off the van in the lift, but won’t always push the person into the doctor’s office for example.

 

????  

I was asking about getting a wheelchair only.

[DawnM]

46 minutes ago, PeterPan said:

We're going through the walking thing with my dad. Getting the wheelchair is easy (amazon, medicare, whatever). But what you might do also is check about therapy for him to improve the walking. He might have some other options, like walking with a walker, and they might be able to get those steps longer by getting them back. Also, the doctor's office should have had a wheelchair. So you could park, run in and get the chair, and run out with it to get him. 

I was surprised to realize the assisted living would rather their people go on the shuttle with a walker (easier to fold/store) and then let the driver run and get a scooter or wheelchair. That's easier for them than dealing with big equipment.

If he can go faster with a walker and with some therapy, that might be safest. My dad went down *very quickly* once he hit this stage and sat down. And that affects how they shower, bathroom, everything.

 

It wasn't a doctor's office, it was the courthouse.

A walker would not have been ideal there, the sidewalks were old style brick with a lot of cracks.   I realized we need a transport chair of some sort for these situations.

[DawnM]

41 minutes ago, J-rap said:

We've had insurance and Medicare cover a wheelchair pretty easily.  I've also donated ones to second-hand stores when we didn't need them anymore, so you can look there as well.  

Does he have a walker now?  There are some with seats where he can stop and rest if he needs to.  I will say that once you have a wheelchair, unless you're particularly motivated, you probably will not ever improve enough to NOT need a wheelchair again.  But of course there's a time when that's completely okay.

 

He has a walker but refuses to use it very much, and, this particular situation yesterday would not have been good with a walker.

[DawnM]

Just now, Seasider too said:

Not sure how much time you have - maybe keep an eye on estate sales? 

Honestly, don't have that kind of time, I work full time, have a foster 3 year old, am working on renovating for my dad to move in, doing all of my dad's shopping, cooking,  and transportation, and dealing with several court dates for our foster situation.

I can do little else, other than sit here and shop online, including CL and FB Marketplace.   

[Catwoman]

I think his doctor can prescribe one, and you will be able to get it almost immediately. They might even deliver it to your house.

That is the first step I would take.

[Catwoman]

I forgot to mention — you might be able to get it prescribed by just calling the office and asking, if you say the need is urgent (like you have to go someplace later in the week and your dad won’t be able to handle the walking.)

[Mrs Tiggywinkle]

1 hour ago, DawnM said:

????  

I was asking about getting a wheelchair only.

I misread it and thought you were talking about Medicare wheelchair transport.

[BlsdMama]

Will  his progression require a power chair? I can’t emphasize getting that answered. It’s SO important. 
 

i have private insurance but my understanding is that Medicare has some of the same rules.

 

The important pieces is this: one chair every five years.

 

So if this is something that may progress then just pay cash for a transport chair. For example I have a fold up “Drive” transport chair. They’re inexpensive but you really need to get him a GOOD padded insert seat.  
If it’s not progressive disregard. A power chair is NOT something you want to pay OOP for. 😉

 

 

[Ottakee]

I agree with @BlsdMama  use the Medicare benefit for the most you can if you might need power in the future.

Do you have a senior center in your city/county?  In our area you can rent transport chairs for a very small amount.  We also have several local charities that have medical equipment for a small fee as well.

[J-rap]

7 hours ago, DawnM said:

He has a walker but refuses to use it very much, and, this particular situation yesterday would not have been good with a walker.

That makes sense.  

In my situation, if there is a random situation where the person I am caring for needs to walk quickly but can't, it's generally in situations where there are wheelchairs or electric carts to borrow -- like at a medical facility, a shopping mall, an airport, even our state fair.   So I'm able to grab one of those and then bring it to the person who needs it.   Can you do that?

[DawnM]

21 minutes ago, J-rap said:

That makes sense.  

In my situation, if there is a random situation where the person I am caring for needs to walk quickly but can't, it's generally in situations where there are wheelchairs or electric carts to borrow -- like at a medical facility, a shopping mall, an airport, even our state fair.   So I'm able to grab one of those and then bring it to the person who needs it.   Can you do that?

well, there weren't any available at the courthouse.   And the church doesn't have any.

[DawnM]

3 hours ago, BlsdMama said:

Will  his progression require a power chair? I can’t emphasize getting that answered. It’s SO important. 
 

i have private insurance but my understanding is that Medicare has some of the same rules.

 

The important pieces is this: one chair every five years.

 

So if this is something that may progress then just pay cash for a transport chair. For example I have a fold up “Drive” transport chair. They’re inexpensive but you really need to get him a GOOD padded insert seat.  
If it’s not progressive disregard. A power chair is NOT something you want to pay OOP for. 😉

 

 

 have no idea.   

[J-rap]

1 hour ago, DawnM said:

well, there weren't any available at the courthouse.   And the church doesn't have any.

Well, probably it is a good idea to get a wheelchair then.  I'd agree with others that you should make sure to get one that folds up easily for the car.  

[BlsdMama]

An inexpensive transfer chair is about $200 on Amazon. A power chair can run above $60,000. A used transfer chair of Marketplace is about $50. Id buy the chair and bypass the insurance. 

[DawnM]

9 hours ago, BlsdMama said:

An inexpensive transfer chair is about $200 on Amazon. A power chair can run above $60,000. A used transfer chair of Marketplace is about $50. Id buy the chair and bypass the insurance. 

if I can find one for $50 I will get it.    But so far I am not finding them for that around here.   People are asking almost fully price, so in that case, I will just buy one from Amazon.

[DawnM]

So, when the doctor writes a prescription, is it for a specific kind of wheelchair?

I would like to go ahead and ask for a power chair.   I think it would be of use.   Although I am not seeing $60k ones.   I am seeing ones that are like $4k.   

[Pam in CT]

When my dad was in the walker / still able to take a few wobbly steps on his own stage , but clearly headed towards greater disability, I spent a good deal of time investigating various options. The short answer is, yes, Medicare definitely does cover wheelchairs, and exactly *which ones and how to actually obtain them* is somewhat complicated. I think the *how* varies by state, so I won't go into all the weeds about what I learned from MA specifically.

At the same time that I was investigating the wheelchair question, I also was learning about various state and local services for seniors, and in so doing I learned what other pp have already mentioned: senior centers / local agencies providing senior services are basically AWASH with wheelchairs donated by the survivors of clients who have died.

So.

What we ended up doing is getting the TRANSPORT wheelchair (where the criteria are weight and ease of collapse... not comfort or turn radius or ability of the senior to navigate independently) from the senior services agency right in my parents' town.  I went to look at what they had available one week before the need was urgent, didn't see any that quite fit the bill (I needed it to be light enough that my mother could lift it out of the trunk); they called me a week or so later that another one had come in that fit my needs, and I went to pick it up at no cost.

For the AT HOME wheelchair that he ultimately needed, that had a lot more bells and whistles, I did go through Medicare.  That required pre-approval with the authorization of a medical professional (I think it was his PT, not a doctor?) from a set list of chairs, and I had to go to a particular distribution center to pick it up.  As I recall, dimly, we had to give it back after he died, but I didn't do that myself so I presume (?) they must have sent someone to pick it up.

[Pam in CT]

re preauthorization

1 hour ago, DawnM said:

So, when the doctor writes a prescription, is it for a specific kind of wheelchair?

I would like to go ahead and ask for a power chair.   I think it would be of use.   Although I am not seeing $60k ones.   I am seeing ones that are like $4k.   

Sorry, I didn't see this before my prior reply.  I do think this is likely to vary a bit by state, but I think the doctor/PT just specifies the *needs* of the patient, not a particular model.

[Matryoshka]

I know a number of people who have gotten free wheelchairs (even some pretty nice ones) for free through a state durable medical equipment exchange.  People who don't need them anymore donate to the group, you call the group and they'll pass on one that is as close as possible to your needs.  This has been life-changing for people I know who either are waiting for their insurance to approve or won't approve one at all.

Not sure if your state has one, maybe Google 'your state durable medical equipment exchange'?

Edited June 6, 2021 by Matryoshka

[Spryte]

Just echoing that Medicare only covers one chair every 5 years.  I would pay OOP for a transport chair and wait till the need is greater so Medicare covers more (power chair, nicer wheelchair). Hopefully you can find a good option!

It does sound like a transport chair would have helped in that situation.  

I know you are short on time, so this might not be helpful, but those short, shuffling steps could be addressed with PT/OT. Maybe mention it to the doc at the next visit and see if that’s an option. 

[prairiewindmomma]

9 hours ago, DawnM said:

So, when the doctor writes a prescription, is it for a specific kind of wheelchair?

I would like to go ahead and ask for a power chair.   I think it would be of use.   Although I am not seeing $60k ones.   I am seeing ones that are like $4k.   

When dd got her chair we went to a seating clinic that did an evaluation of a variety of factors including what transportation we had and could acquire. They also considered whether she had the strength and hand control to self propel, who her support people were, and what our home situation was like. She needed additional cushioning and set up for an iv pole and oxygen, and so a number of things factored in.

Keep in mind if he is getting a power chair he can only be transported in it in a vehicle with a lift.

We weren’t in the Medicare/Medicaid system but many of the clients at the seating clinic were—same process at that end of things.

 

[KungFuPanda]

Try looking into any local medical equipment loan closets.  Sometimes those places have so much inventory that they won't even take more donations.

[DawnM]

On 6/6/2021 at 12:14 PM, Matryoshka said:

I know a number of people who have gotten free wheelchairs (even some pretty nice ones) for free through a state durable medical equipment exchange.  People who don't need them anymore donate to the group, you call the group and they'll pass on one that is as close as possible to your needs.  This has been life-changing for people I know who either are waiting for their insurance to approve or won't approve one at all.

Not sure if your state has one, maybe Google 'your state durable medical equipment exchange'?

The only one I see is for low income.

[DawnM]

On 6/6/2021 at 1:33 PM, Spryte said:

Just echoing that Medicare only covers one chair every 5 years.  I would pay OOP for a transport chair and wait till the need is greater so Medicare covers more (power chair, nicer wheelchair). Hopefully you can find a good option!

It does sound like a transport chair would have helped in that situation.  

I know you are short on time, so this might not be helpful, but those short, shuffling steps could be addressed with PT/OT. Maybe mention it to the doc at the next visit and see if that’s an option. 

He needs a hip replacement and has fallen a few times.   He is trying not to fall.   I highly doubt he will go to PT or OT.    Stubborn, old (lovable) mule! 😜

He is refusing a hip replacement and says the risk is greater than it is worth at his age (86) and my guess is that they probably both need replacing now.   He has had 3 hip replacements throughout his life.

[DawnM]

thanks guys.   I took him to the doctor today and the doctor had no problem writing him a prescription for a motorized wheelchair.   I will keep looking for an inexpensive used transport chair or just order one.

[DawnM]

Now......any recommendations for a wheelchair?   I am thinking it would be nice to have one that doesn't have the controls in the front, so he can use it to roll up to his desk, his eating table, sink, etc.....so not the jazzy type.

[Scarlett]

How is the remodel coming?

 

[KungFuPanda]

25 minutes ago, DawnM said:

Now......any recommendations for a wheelchair?   I am thinking it would be nice to have one that doesn't have the controls in the front, so he can use it to roll up to his desk, his eating table, sink, etc.....so not the jazzy type.

Jazzy has both types of power scooters.  I currently have one of the ones with the controls on the side (the kind that looks like a power wheelchair) and I can't even give the thing away,  Do you happen to be in Maryland? (I never remember where ANYONE lives.)

[DawnM]

9 minutes ago, KungFuPanda said:

Jazzy has both types of power scooters.  I currently have one of the ones with the controls on the side (the kind that looks like a power wheelchair) and I can't even give the thing away,  Do you happen to be in Maryland? (I never remember where ANYONE lives.)

I wish!   I live in North Carolina.   Wanna bring it down?   Nice vacation maybe???? 😜

[DawnM]

19 minutes ago, Scarlett said:

How is the remodel coming?

 

Good.   Triple the timeline they quoted, but whatever.   It should be done by the end of June.

[Catwoman]

1 hour ago, DawnM said:

thanks guys.   I took him to the doctor today and the doctor had no problem writing him a prescription for a motorized wheelchair.   I will keep looking for an inexpensive used transport chair or just order one.

Yay!

I’m giving your thread a bump for more suggestions. 🙂 

[Scarlett]

1 hour ago, DawnM said:

Good.   Triple the timeline they quoted, but whatever.   It should be done by the end of June.

Ugh.  So typical.  But glad it is moving forward.

[Matryoshka]

21 hours ago, DawnM said:

The only one I see is for low income.

That's a shame.  Ours must not have that qualifier, or the people I know who got them wouldn't have qualified.

[KungFuPanda]

1 hour ago, DawnM said:

I wish!   I live in North Carolina.   Wanna bring it down?   Nice vacation maybe???? 😜

Can't even GIVE the thing away!  Ugh.  Maybe I'll try the MDA loan closet again and see if they have reopened for donations.  I haven't called them in a year.

[Ottakee]

You should be able to go to a rehab hospital, etc for a wheelchair evaluation.   They can look at his height, weight, mobility, figure needs, etc and suggest a chair base, seating system, type of controls, etc.

It isn't as simple as just saying I like chair x in blue please.

I work with special needs students and we have had over 100 in wheelchairs....and each and every one was different based on their needs 

[DawnM]

7 minutes ago, Ottakee said:

You should be able to go to a rehab hospital, etc for a wheelchair evaluation.   They can look at his height, weight, mobility, figure needs, etc and suggest a chair base, seating system, type of controls, etc.

It isn't as simple as just saying I like chair x in blue please.

I work with special needs students and we have had over 100 in wheelchairs....and each and every one was different based on their needs 

 

Right, but he doesn't need it as much as a SPED student would, and just needs it for some extra mobility, which I think is quite different.

[BlsdMama]

8 hours ago, DawnM said:

Now......any recommendations for a wheelchair?   I am thinking it would be nice to have one that doesn't have the controls in the front, so he can use it to roll up to his desk, his eating table, sink, etc.....so not the jazzy type.

I have a Permobil F5 VS.  It has full head plus stand so he wouldn’t need that. Read the difference between mid wheel placement and front wheel placement. It matters but I can’t remember why. I have a gel and air seat cushion. Best thing ever. 
 

FYI - the hand controls swivel out of the way. They are at my natural hand extension for driving but push out and back for seating at a table.
 

Elevate function is GOLD if it can be justified.  I like tilt too. 
 

Wheelchairs are interesting. Each “upgrade” must be justified. My physical therapist sat in on the meeting and helped me choose necessary features. You need a meeting with a durable medical equipment person so he can try out chairs. This is the most important (and most expensive) purchase we made except our house in our lifetime. 

[BlsdMama]

4 hours ago, DawnM said:

 

Right, but he doesn't need it as much as a SPED student would, and just needs it for some extra mobility, which I think is quite different.

But again an experienced person, well versed, wold know your needs (and future needs) better than you would. It borders on awkward because, even with all my research, I didn’t always know the purpose of a particular function. For example, elevate. What do I care of my chair goes up and down? Well, it turns out that I need it for later to lie flat and be put into bed. I hadn’t realized my chair would be a tool to get into bed!

[Ottakee]

1 hour ago, BlsdMama said:

But again an experienced person, well versed, wold know your needs (and future needs) better than you would. It borders on awkward because, even with all my research, I didn’t always know the purpose of a particular function. For example, elevate. What do I care of my chair goes up and down? Well, it turns out that I need it for later to lie flat and be put into bed. I hadn’t realized my chair would be a tool to get into bed!

Yes.  So many things to consider that those of us not trained in this stuff don't even consider.  Turn radius is huge.  Wheel base width and length...makes getting in and out of different lift vehicles easier or harder.  Tilt, hand control placement,  seating and backrest angles, and on and on.

[DawnM]

I FINALLY found a manual wheelchair today, used.   The chair was in great condition and free, but it didn't come with foot rests so I did order those for $30 on Amazon.

It is this one:

https://www.home-med-equip.com/catalog/medline-excel-transport-wheelchair-mds808200.html

[Catwoman]

Just now, DawnM said:

I FINALLY found a manual wheelchair today, used.   The chair was in great condition and free, but it didn't come with foot rests so I did order those for $30 on Amazon.

It is this one:

https://www.home-med-equip.com/catalog/medline-excel-transport-wheelchair-mds808200.html

Yay!!! I’m so glad you got one!!!

[Kassia]

Great news!  🙂