Medicare Coverage for Manual Wheelchairs
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Questions and Answers

What is the main criterion for a manual wheelchair to be covered by insurance?

  • The beneficiary's mobility limitation cannot be sufficiently resolved by the use of an appropriately fitted cane or walker (correct)
  • The beneficiary has sufficient upper extremity function and other physical and mental capabilities needed to safely self-propel the manual wheelchair
  • The beneficiary has expressed a willingness to use the manual wheelchair
  • The beneficiary has a caregiver who is available, willing, and able to provide assistance with the wheelchair
  • What is a mobility limitation according to the text?

  • A limitation that prevents the beneficiary from completing an MRADL within a reasonable time frame
  • All of the above (correct)
  • A limitation that places the beneficiary at reasonably determined heightened risk of morbidity or mortality secondary to the attempts to perform an MRADL
  • A limitation that prevents the beneficiary from accomplishing an MRADL entirely
  • What is the additional criterion for a transport chair to be covered by insurance?

  • Basic coverage criteria A-E and G must be met (correct)
  • The beneficiary requires a lower seat height (17" to 18") because of short stature or to enable the beneficiary to place his/her feet on the ground for propulsion
  • The beneficiary self-propels the wheelchair while engaging in frequent activities in the home that cannot be performed in a standard or lightweight wheelchair
  • The beneficiary meets both criteria (1) and (2): Cannot self-propel in a standard wheelchair in the home; and The beneficiary can and does self-propel in a lightweight wheelchair
  • What is the specific criterion for a standard hemi-wheelchair to be covered by insurance?

    <p>The beneficiary requires a lower seat height (17&quot; to 18&quot;) because of short stature or to enable the beneficiary to place his/her feet on the ground for propulsion (C)</p> Signup and view all the answers

    What is the specific criterion for a high strength lightweight wheelchair to be covered by insurance?

    <p>The beneficiary has a caregiver who is available, willing, and able to provide assistance with the wheelchair (A)</p> Signup and view all the answers

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