Thursday, March 12, 2015

Medicare and Private Insurance

Hi everyone,

I received an email from Sigrid, who is working on getting a TravelScoot for Lila, and is asking if anyone here dealt with a similar situation involving Medicare and/or private insurance, and if so, what were the results? Below are excerpts from her email. If you have any advice, please post it in the comments or send it to me,, and I'll pass it on. 



From Sigrid:

First I'd like to thank you for your blog. It's been very helpful as we try to choose a mobility scooter for my housemate (Lila).

We're well aware that Medicare is very strict about paying for a mobility scooter and only does so in very rare instances. We're wondering if her situation might possibly be one of those rare instances. 

Apparently this is the situation with Medicare and insurance companies:

Medicare and most insurance companies will only approve reimbursement of a mobility scooter ( non-travel type) if the individual is unable to operate a manual wheelchair and the scooter is medically required to sustain the individual's daily living within the 4 walls of his/her home. A person who can stand and walk small distances will generally not be approved by Medicare or private insurance for any type of mobility scooter.

We are moving to a retirement facility. Fees at the facility include all meals.  Meals are not optional. Lila is unable to walk the distance to the dining area. While the dining room is technically not within the 4 walls of our apartment, in reality it has to be considered as such as one does have to eat and she needs to be able to get to the dining room :-). It IS one of the activities of daily living.

I know you can't speak for Medicare, or any insurance carrier, but I'm wondering if you're aware of any TravelScoot purchaser who had the same situation Lila will face and was able to get Medicare or their insurance carrier to grant an exception and pay at least something toward the purchase of a TravelScoot?