Does Medicare Pay for Transport Chairs?
When working with clients and their families, one common question that I am asked is, “Does Medicare pay for transport chairs?” The short answer is, “Yes,” but the bigger question is, “Should I use my Medicare Benefits to Pay for a Transport Chair?” The answer to that question is a little more complicated.
What is a Transport Chair?
Before we answer questions about Medicare benefits and coverage, we should first answer the question, “What is a transport chair?” A transport chair is a small, lightweight, portable wheelchair that is designed for short-term, short-duration use. A transport chair can be helpful to transport someone to and from appointments, community events, or social gatherings. Transport chairs are easy to fold and put in the back of a car for easy transport (hence their name). Transport chairs are NOT designed to serve as someone’s primary means of transportation or mobility. Due to the lightweight nature of the design, there is not much emphasis on comfort, cushioning, or positioning. For more information, please see our blog post on “What is the Difference Between a Transport Chair and a Wheelchair?” and “How to Choose a Transport Chair.”
Will Medicare Pay for a Transport Chair?
As mentioned before, yes, Medicare and other insurance companies will cover all or part of the cost of a transport chair. The coverage amount depends on the insurance company, but Medicare typically covers 80% of the cost. If you have a secondary insurance policy, they may pick up the remaining 20%. as long as the person using it meets the following qualifications (This is a summary, complete guidelines are available on the Medicare Website):
The client has a mobility limitation that significantly impairs their ability to complete self care tasks.
The mobility limitation cannot be resolved using a cane or walker.
The client’s home has adequate access for use of the chair.
The chair will significantly improve their ability to complete self-care tasks in the home and they will use it on a regular basis.
The client is willing to use the chair.
The client has caregivers who are available and willing to assist with use of the chair.
The client cannot use any other type of chair to accomplish this.
Should I use my Medicare Benefits to Pay for a Transport Chair?
The reason I raise the question “Should I use my Medicare Benefits to Pay for a Transport Chair?” is that the criteria listed above for transport chairs are the exact same criteria required for a standard wheelchair. This means, that if you use your Medicare benefits to pay for a transport chair, and after a few months or years, the need for a more customized wheelchair arises, Medicare will likely deny paying for another chair. There are a few reasons why this is the case:
In asking Medicare to pay for a transport chair, you have already used the justifications needed for a manual wheelchair and have told Medicare that a transport wheelchair is the BEST option to meet your needs. They will not provide multiple devices with the same justification, meaning you cannot have Medicare pay for a transport chair AND a standard wheelchair within a 5 year timeframe.
To get a transport chair, you are also telling Medicare that you are unable to propel yourself in a wheelchair, hence the need for someone to push you in a transport chair. Wheelchairs are designed to allow people to propel themselves. If you have already told Medicare that you require a transport chair, and then turn around and tell them that you need a wheelchair to be able to ambulate on your own, they will deny it based on your previous claims.
I am not trying to discourage anyone from using the Medicare benefits that they are absolutely entitled to. I just want to encourage you to be thoughtful about how you utilize them, as your decisions may impact your ability to get other medical devices and equipment approved in the future. If you have questions about choosing a transport chair, wheelchair, or other devices, this is a great time to seek out an assessment with an occupational therapist or physical therapist to help guide you through your options and the process. If you are looking to purchase a transport chair, please see our post on “How to Choose a Transport Chair” to learn about your options. Alse please check out our blog posts on “What’s the Difference between a Wheelchair and a Transport Chair?”, “Does Medicare Pay for Wheelchairs?”, or our YouTube video to learn more. Also feel free to check out our book, “A Therapist’s Guide to Caregiving” for detailed instructions on how to help your loved one with their mobility devices. Also, feel free to check out our full video training course for detailed video instruction.
A Therapist’s Guide to Caregiving
The book includes 170 pages of full-color, step-by step instructions, to provide you with all the skills you need to provide safe, thorough, and compassionate care at home.
This is your comprehensive guide to giving you with the skills you need to provide safe, effective, and compassionate care to family members, friends or clients in the home. This course includes 6 hours of instructional video covering client basic adaptive equipment, functional mobility, lifting techniques, transfers, self-care skills, bed level care, use of client lifts and transfer devices, and managing falls. Click "Preview Caregiver Course" below to preview the lessons and descriptions.
