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Medicare and power chairs: the effects of the health reform act

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Power wheelchairs are unique medical devices that bring independence to thousands of senior citizens each and every day. However, Medicare power chairs have made the news recently not because of their mobility-enhancing capabilities, but rather as a major player in the recently signed health reform bill, or more specifically, the Patient Protection and Affordable Care Act.

The PPAC Act eliminates the first-month purchase option for power wheelchairs. Prior to President Obama signing this act into law on March 23, 2010, Medicare would generally pay 80 percent of the price of a power chair within the first month of the patient receiving his or her chair.

However, since this provision went into effect on Jan. 1 of this year, power chair providers are now receiving Medicare reimbursement stretched over a 13-month period. In a sense, power chair providers have become renters rather than sellers.

The question still remains: How will all this affect the beneficiaries – those who actually need the added mobility and independence offered by a power wheelchair?

The simple answer is that the process for having Medicare cover the cost of a power chair won’t be any different than it was prior to PPAC Act going into effect. By and large, this remains a four step process:

1. Contact a power wheelchair provider to discuss your options and get assistance with scheduling a mobility examination with your doctor.

2. Visit with your physician. Whether you have fallen recently or are suffering from a lack of balance, it is important to discuss all current mobility issues with your doctor so that he or she can prescribe the proper solution for you.

3. Upon receiving a power chair prescription from your doctor, power chair companies will assist in any required Medicare documentation. These same companies will also submit the forms on your behalf, thus saving you the trouble of going through the Medicare application process.

4. Finally, if approved, the supplier will deliver the power wheelchair right to your home, train you on how to use it and adjust the settings so that the chair comfortably fits your body type.

Medicare beneficiaries will see some slight differences in any applicable co-pays and/or deductibles. Previously, co-pays and deductibles were paid in one lump sum. Now, with the new provision in place, that is stretched over 13 months.

This results in a 5 percent increase in the overall cost for the power chair, so while the total cost to beneficiaries may be slightly higher, it will be spread over a longer timeframe. Also, the actual ownership of the power chair isn’t transferred to the beneficiary until the payment period is complete and all payments are received.

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