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Thread: Does medicare Cover Invacare Gearless/Brushless motors?

  1. #1

    Does medicare Cover Invacare Gearless/Brushless motors?

    Hi All,
    I'm in the process of getting a new chair & have some questions. My new vendor says Medicare won't cover Gearless/Brushless motors on my new chair. I forget the exact reason why but I believe he mentioned them only being prescribed for ppl weighing 300+ pounds. I do have them on my current chair but got it when I was working & had United Health as primary my primary insurer, theyre now 2nd to MC.

    I called a rep at my old vendor & he said theyve never had a problem getting the GB motors covered. Anyone have info on this? Can those w/GB motors please let me know what if any special prescriptions or letters of med. necessity you had to get? Thanks.
    Daniel G.

  2. #2

    Gearless Brushless

    Quadzilla,
    I'm new to this forum, I just stumbled on it today, and it seems to me that no one has responded to your question. The answer to your question is no, Medicare does not pay for gearless brushless motors. The reason is a bit complicated, but basically, Medicare pays for the least costly intervention.
    A wheelchair is covered only for use in your home with no consideration for any activity that may take place outside the home.
    Medicare has recently gone off the deep end with coverage of mobility equipment. You can visit the Medicare mobility website at: http://www.cms.hhs.gov/CoverageGenIn...wheelchair.asp which will give you more information.
    Additionally, new "Local Coverage Determinations" have just been published which, if enacted, threaten your ability to get anything but the bare minimum of equipment.
    I hope this helps. Please feel free to contact me directly if you need more help.
    Highlander
    gdcrts@aol.com

  3. #3
    Hi Quadzilla,

    I don't know the advantages of brushless motors because I'm in a manual chair. But you'll need to convince the doctor who writes up the paperwork for your powerchair that you need them for your "Mobility Related Activities of Daily Living" (MRADLs). Since you said that they are only prescribed for people weighing over 300 pounds I imagine they are stronger motors.

    Maybe you could convince (wink and nod perhaps) your doctor that you have a very steep backyard that you need to access everyday or that you need to traverse a very long and steep street everyday etc so you need the more powerful motor to perform your "Mobility Related Activities of Daily Living" (MRADLs). It appears as though they are more expensive (a "luxury item!) so you need to "prove" to Medicare's satisfaction that they are medically necessary in order for you to perform your MRADLs.

    Or you could gain a "few" pounds!!!

    I just got a new manual Quickie GPV chair from Medicare with a few "extras" on it so had to do this. Sometimes your SCI doctor or PT will have a standardized "Functional Mobility Evaluation" form (mine was 5 damn pages long) but got mine from my local wheechair vender who I ordered my chair through. The State of Idaho has one posted online that you can print out. The Google page is HERE and just click on where it says "FUNCTIONAL MOBILITY EVALUATION Must complete the entire form..." It's in printable PDF form.

    Play their game.

    Good luck.
    "Be kind, for everyone you meet is fighting a great battle." - Philo of Alexandria

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