Wheelchair Prescription (What is it & How to get one)

When you need moving or walking, it may be time to think about getting a mobility aid like a wheelchair. Some of the first steps to getting a wheelchair are speaking to your doctor and explain your situation to them. When doing this, your physician may give you a wheelchair prescription if you indeed need help moving with the aid of a wheelchair.

Your doctor will first check your ability to walk to see if you need this type of mobility aid before a prescription can be written. Once your doctor has determined that a wheelchair will benefit you, the doctor will then prescribe along with the medical information to a wheelchair supplier that is also approved. A doctor typically does this wheelchair evaluation process.

What is a wheelchair prescription?

Wheelchair prescriptions are given to you by your doctor once they conclude that you need a wheelchair to safely and adequately move. Your doctor will then write you a prescription for a wheelchair from an insurer-approved supplier of wheelchairs. Depending on your needs, these wheelchairs can be manual wheelchairs or even power wheelchairs.

Wheelchair prescription components

The wheelchair prescription comprises two primary components: a seat surface and a seat surface (seat and backrest). 7. The medical practitioner should assume there is a power base for people with cervical SCI. In the event of disability, a wheelchair should not be adapted to accommodate a wheelchair user whose physical and mental conditions may require special assistance. Wheelchairs are complex technology (CRTs) that support SCI patients’ optimal physical mobility and health.

How do I get a wheelchair prescription?

Getting a doctor’s prescription is not difficult when you want a wheelchair. You may be hurting, and the damage is apparent; you should speak to a doctor if there’s a way to get around it. Mobility problems resulting from old age or illness will need more evidence, particularly when changing doctors. However, once a medical history is reviewed, it shouldn’t be difficult for the patient to find the support necessary for their productive lifestyle. Some people are uncomfortable talking about mobility and disability issues. This is an excellent way to relax.

Wheelchair Prescription Process and Medical Documentation

Wheelchair prescribing is usually followed as in Figure 1. The doctor’s primary responsibility involves the thorough investigation and documentation of medical conditions which require new mobility devices. In most cases the Medicare or many other insurance carriers require an individualized face-to-face encounter between the patient and physician at least a month after receiving their prescription to obtain an electric motor or wheelchair. It is a face-to-face meeting involving an evaluation of a PC and seating specialist.

What type of insurance covers wheelchairs?

Electric Wheelchair Prescription

Some wheelchairs can be ordered from a physician to a person on Medicare/Medicare. Medicare Part B covers power-operated vehicle scooters or manual wheelchairs that your doctor may prescribe for your home. These mobility aids fall under durable medical equipment, and While Medicare covers this wheelchair, the supplier must accept the job and pay 20% of the Medicare payment. Once all these conditions are fulfilled, Part B will become deductible. The amount billed by these suppliers will not exceed the maximum allowed. Learn more about Medicare coverage here.

Benefits of receiving a wheelchair prescription

Those who suffer from long-lasting and short-term disabilities can benefit from a wheelchair prescription. In addition, those with significant mobility issues such as spinal cord issues, paraplegic patients, M.S., and other issues will need wheelchairs.

Even someone with broken bones in short-term need of a wheelchair can benefit from a wheelchair prescription from either a doctor, health care professional, physical therapist, or occupational therapist.

Why do insurance companies want you to get a prescription?

In general, people will need prescriptions for wheelchairs as the cost of such devices will be too expensive and challenging. However, some wheelchair models have insurance coverage according to their insurer.

Insurance providers will cover wheelchair cases if they have an adequate policy. However, if the patient is deemed necessary, the insurance company can ask for medical testing and receive the prescription for wheelchairs if they believe this will prove crucial.

How Can Insurance Help With Wheelchair Costs?

A significant problem for families with special needs is the additional costs for their children. But, of course, this is only one of many essential items a loved one with specific needs can need. According to diagnosis, the list can be quite lengthy—and costly. Therefore having a company to pay for this cost is vital in a family.

Payment plan options

Most doctors’ offices work with patients and their families if their insurance covers a portion of the fee; it might be in payment plans like monthly payments to lease or buy a wheelchair. There will be no need to spend huge sums on transportation and a mobility grant for your friend. The payment plan is beneficial when renting or purchasing wheelchairs from a healthcare facility or a specialized wheelchair supplier. Ask your doctor about this option at their clinic and if they can recommend you to a wheelchair manufacturer.

Reduced out of pocket costs

The health insurance that the insurer pays will eventually cover the cost of medical care, including purchasing or maintaining the wheelchair. Therefore, all of your expenses are eliminated, reducing stress for your family when shopping for wheelchairs for yourself. You can also buy medical supplies and medications for someone in need.

How much coverage can you get with wheelchairs?

In general, wheelchairs are less expensive for people with private and government insurance than those who have their own. But people are faced with enormous paperwork and responsibilities to secure insurance.

Mobility Advisor says the policy can cover between 50 and 80 percent of wheelchair expenses. The coverage that a person typically gets for medical care depends mainly on the type of insurance. Most insurers look at this as follows:

What if insurance doesn’t cover wheelchairs

If your insurance does not cover the cost of a wheelchair, then purchasing a chair out of pocket is probably still worth it simply because it provides a safe and effective way for you to stay mobile. Of course, pricing will come into play for some of us, but there are affordable, and even payment plans that many larger retailers will have available when purchasing a wheelchair out of pocket.

What type of wheelchairs can you get with a wheelchair prescription?

Types of wheelchairs

Both manual wheelchairs and power wheelchairs can be written for your doctor in a prescription. Depending on your needs, what your doctor feels you will need to stay mobile properly will determine what type of manual wheelchair configuration you need. For example, those with upper limb function may opt for a manual wheelchair. Those that suffer more severe issues like spinal cord injury or other problems that limit the use of arms will need to look for power or electric wheelchairs.

Manual Wheelchairs and Insurance Coverage

According to Health Cost Helper, manual wheelchair costs are generally cheaper, with an average of around $500. This wheelchair is usually basic and usually used only for a couple of days.

The wheelchair will be about $500 – $4,000 for typical use. The cost varies depending on several variables, such as: For the specifications above, you will need an insurance prescription. If the wheelchair gets altered, the price will increase, so prescriptions will help cover the cost.

Manual Wheelchairs

This is the wheelchair of the longest period of existence. Modern technology has also made wheelchairs more comfortable for wheelchair users. Manually adjusted wheelchair systems can ensure any activity can happen by hand in a wheelchair or by using it.

Many manufacturers will add larger tires for the outdoor. It also added another wheel to the rear and hands for a hand-held pedal to convert the bicycle into the car.

Motorized Wheelchairs and Insurance Coverage

The Powerchair can become somewhat more expensive due to its additional components. This set is typically about $1200 to $1500 in the lower range, while fully customizable chairs cost about $30,000. The average Power Chair costs 7332.90 in the U.S. The average Chair is 7432 dollars.

Moreover, users are generally charged extra mainly due to its mechanical nature. Batteries should not be a big deal, but the batteries will change; they usually have no full insurance coverage unless the batteries need replacement.

Motorized wheelchairs

These wheelchairs with motors are called “power chairs” and are generally powered by batteries powered by the wheel. The Joystick on the handrail of the vehicle controls the wheel and movement in general. Basic motorized wheelchairs can be used indoors and on paved surfaces and are customizable; they can be rolled around more challenging terrain. However, most people who use wheelchairs prefer independence when the wheelchair is used to aid their everyday activities.

What to consider when deciding on a wheelchair

There are many different wheelchairs to choose from for those with mobility limitations. Manual wheelchairs and power wheelchairs are the types of wheelchairs you will be choosing from. Manual wheelchairs are mobility aids that the user will either manual propel or have a caregiver push for the person sitting in the Chair. There are essential elements to look at before purchasing a wheelchair.

The weight of the wheelchair: Most people opt for a lightweight wheelchair as these chairs are easier to lift, transport, and wheelchair propulsion is easier for most. Ultra-light or lightweight chairs can range from 13.5 lbs. to 35 lbs. in most cases.

Weight capacity: After getting a wheelchair prescription and searching for a wheelchair, you will want to know the wheelchair weight capacity. This capacity is the weight a user can sit safely while using the wheelchair. Most lightweight wheelchairs can safely have a weight capacity of up to 250 pounds.

Wheelchair cost: The wheelchair cost will vary greatly depending on the model and make. Typically you will see wheelchairs in 250 to 750 or more for a manual wheelchair. Power wheelchairs will go up significantly because of the chairs’ components and complexity.

Proper wheelchair size: Make sure to measure yourself before purchasing a wheelchair properly. The right seat height and wheelchair base are essential to a comfortable experience and safer experience when using a wheelchair. Using a wheelchair that is too large will have an increased risk of falling or further hurting yourself.

Positioning and seating: Positioning is a practice to identify optimum body placement for a client while wheelchair chairs are inserted in such positions. Seats are available in manual or power-chair bases. In addition, wheelchair-accessible bases need seating that meets individual needs.

Comfort: Wheelchair users should feel comfortable while sitting in a wheelchair, especially for long periods. Postural support add-on systems, wheelchair cushions, and other accessories support while sitting in a chair. The correct pressure relief cushion can not only prolong wheelchair use but make sitting for long periods comfortable.

Seating and Wheelchair Assessment

Wheelchair seating

Generally speaking, the assessment of seat position is based upon obtaining information about the situation and goals identified and it also assesses current position mobility and equipment. Basic demographic information including age and weight, medical diagnoses and the accompanying condition (including, if diagnosed progressively), medical history and treatments.

How long does a wheelchair need to last?

The length of time you need a wheelchair varies depending on their needs. The longer people need wheelchairs, the higher the price of these chairs. It’s unlikely that wheelchairs will be costly for the primary surgical procedure. However, if we need a wheelchair for more than three months, our costs will increase. This is because insurance firms cover whatever they choose, and if a longer duration is required, the insurer can show that the disability expense cannot be covered. This is partly to provide a flexible wheelchair for long periods of usage.

Is wheelchair use a cost-effective solution?

If people have mobility issues, they will generally have more money for their insurance and other expenses. Other options for using walking boots and crutches in place of walking shoes or walking boots can also be used. However, different conditions might need wheelchairs, such as: In some cases, such as paralysis or neurological disorders, the wheelchair is a permanent function for the patient. If someone uses a wheelchair for long periods, they are severely hurt.

Final thoughts

If a person with a particular need or disability is asked to use wheelchairs, this can be incredibly stressful. Moving from walking into a wheelchair can be challenging, as people can no longer have freedom of movement. However, a wheelchair enables one to return the freedom and mobility of an individual who otherwise cannot move. You don’t have to have prescriptions for wheelchairs. If you want a low-cost option to reduce your insurance costs, it’s worth it.

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About ASmith

Adam Smith is the main researcher and contributor at Mobility Medical Supply. Adam has many years of research in public data, and software security. With Mobility issues within Adam's family, he decided to dedicate in-depth guides on mobility products to anyone looking to improve movement and gain independence.