Does Medicare Cover Upright Walkers?

If you or a loved one needs a little help getting around these days you might be wondering “Does Medicare cover upright walkers?” The answer isn’t so straightforward, but don’t worry—we’ve got you covered. Medicare does offer some help with medical equipment, but there are important details and potential pitfalls (some even funny) that you should know.

Let’s dig into what Medicare will and won’t do for your upright walker needs.

Medicare Part B and Durable Medical Equipment (DME)

Medicare Part B covers Durable Medical Equipment (DME), and that’s where things like walkers come into play. However, an upright walker is a little more specialized than the traditional walkers you might picture, and Medicare is often a little picky when it comes to the type of equipment it covers.

What exactly is an upright walker?

An upright walker is designed to help you walk in a more natural position without hunching over like you’re trying to find your car keys on the floor. Instead of leaning forward on traditional walkers, upright walkers encourage an ergonomic stance that’s much better for posture.

They can be super useful for people who have difficulty using standard walkers. But does Medicare pay for these fancy upgrades? The answer is… maybe.

What’s the process for Medicare coverage?

Step 1: Does it qualify as DME?

Medicare only covers walkers that meet its definition of DME. Here’s what that means:

1. It must be durable (expected to last at least three years)
2. Used for a medical purpose (not for racing your neighbor down the block)
3. Not useful to someone who isn’t sick or injured (otherwise it’s just an expensive coat rack)
4. Used in your home (they don’t care if you use it at the grocery store)

Step 2: Is it medically necessary?

Medicare also requires that your upright walker be prescribed by a doctor and deemed “medically necessary.” Your doctor will need to justify that you require an upright walker rather than a standard one. This is where things get tricky. Upright walkers are often considered “upgrades” to standard walkers and may not always be seen as a necessity by Medicare.

“We’ve seen it happen where someone absolutely needs an upright walker for their health and comfort but Medicare considers it just an extra luxury” says Henry Beltran the owner of Medicare Advisors Insurance Group LLC.

Will Medicare Pay for the Upright Walker?

In most cases Medicare will cover a basic walker and you might have to pay the difference if you want the extra perks of an upright walker. So the short answer is Medicare might help you out with part of the cost but not necessarily all of it.

Here’s how the costs might break down:

• Medicare typically covers 80% of the cost of DME after you meet your Part B deductible
• You’ll be responsible for the remaining 20%

But, a few important things to note:

• Medicare Advantage plans might offer more flexibility and cover the cost of an upright walker more fully. It’s worth looking into!
• You may need to get your walker from a Medicare-approved supplier to qualify for coverage. So no ordering off your favorite online shopping site.

Potential Drawbacks of Upright Walkers (and Some Humor!)

While upright walkers are a big improvement for many people they do come with a few drawbacks:

• Bigger is not always better: These walkers are often bulkier than standard ones. If you’ve got a tiny apartment good luck maneuvering around that tiny hallway. You’ll feel like you’re driving a semi through a narrow alley!
• Price tag alert: Upright walkers are usually more expensive. You might end up feeling like you’re paying for a Cadillac when you just needed a bicycle.
• Assembly Required: Some upright walkers can require assembly. And if you’ve ever tried to put together an Ikea bookshelf you know how that can turn out. Just imagine trying to figure out which screw goes where when you just need to go for a walk.

Alternatives to Upright Walkers

If Medicare doesn’t cover your upright walker fully or if you’re looking for alternatives here are a few options:

1. Traditional walkers: The basic model might not be as fancy but it’ll get you where you need to go. Sometimes simple is better.
2. Rollators: These are walkers with wheels and a seat so you can rest when you need to. Medicare often covers these at a lower cost.
3. Secondhand equipment: If budget’s tight try looking for used medical equipment from local groups or charities.

How to Get Started With Your Medicare Coverage

Step 1: Talk to Your Doctor

You’ll need a prescription for any walker covered by Medicare. So start by discussing your mobility needs with your doctor. They can help decide whether an upright walker is the right choice for you or if Medicare would prefer you stick with a traditional walker.

Step 2: Find a Medicare-approved supplier

Once you have your prescription, find a Medicare-approved supplier for your equipment. You can use Medicare’s online tool to search for suppliers in your area. Make sure to get approval before purchasing—otherwise, you might be left footing the whole bill yourself.

Step 3: Look into Medicare Advantage

If you’re not getting the coverage you need through Original Medicare it’s worth checking out Medicare Advantage plans. Many of these plans offer extra benefits, including broader coverage for things like upright walkers.

Key Takeaways

1. Medicare Part B covers walkers but might not cover an upright walker unless it’s deemed medically necessary.
2. Expect to cover 20% of the cost unless you have a Medicare Advantage plan with more extensive coverage.
3. Upright walkers can be bulkier and more expensive but offer significant benefits in terms of posture and ease of movement.
4. Alternatives like rollators may be covered at lower costs.

Conclusion

At the end of the day whether Medicare covers your upright walker depends on a few factors. But you don’t have to navigate it alone. “We’re here to help make sure you get the equipment you need with as little hassle as possible” says Henry Beltran. “Don’t let Medicare’s complex rules get you down—we’ve got the expertise to guide you through it”.

For more information on your Medicare coverage options, feel free to reach out to Medicare Advisors Insurance Group LLC. We’ll help you walk through (pun intended!) the process of getting your upright walker or whatever equipment suits your needs best.

FAQs:

1. What is the average cost of an upright walker?
   • Typically between $200 and $600, depending on features.
2. Can I upgrade my walker?
   • You may have to pay the difference if Medicare only covers the basic model.
3. Do I need a prescription for a walker?
   • Yes, Medicare requires a doctor’s prescription for any DME.