What Is Hoveround and How Medicare Covers It

Hoveround is a manufacturer of power wheelchairs and mobility solutions designed specifically for individuals with mobility limitations. These power wheelchairs are compact, allowing users to navigate tight spaces more easily than traditional wheelchairs or scooters. For many seniors and disabled individuals, these mobility devices represent freedom and independence.

Medicare Part B (Medical Insurance) may cover power wheelchairs like those manufactured by Hoveround when they're deemed medically necessary. This typically requires that you have a mobility limitation that significantly impairs your ability to perform activities of daily living within your home. Your doctor must provide documentation that other mobility aids like canes, walkers, or manual wheelchairs won't suffice for your condition.

When approved, Medicare typically covers 80% of the Medicare-approved amount for the power wheelchair after you've met your Part B deductible. The remaining 20% would be your responsibility, though this may be covered by supplemental insurance if you have it. It's important to note that Medicare will only cover a power wheelchair for use in your home, not primarily for outside activities.

Medicare Eligibility Requirements for Hoveround Coverage

To qualify for Medicare coverage of a Hoveround power wheelchair, you must meet several specific criteria. First, the physician who treats your condition must examine you and provide a written order stating that you have a medical need for a power wheelchair. This examination must specifically address your mobility needs and take place before the wheelchair is delivered.

The documentation must clearly establish that:

  • You have a mobility limitation that significantly impairs your ability to perform activities of daily living within your home
  • You cannot operate a manual wheelchair or scooter, or you don't have the upper body strength or stamina to safely use these devices
  • You can safely operate the power wheelchair controls
  • You can transfer safely in and out of the power wheelchair
  • Your living environment can accommodate the use of a power wheelchair

Additionally, the supplier providing your Hoveround must be enrolled in Medicare and accept assignment, meaning they accept the Medicare-approved amount as payment in full. Working with a Medicare-enrolled supplier ensures that Medicare will help pay for your power wheelchair.

Power Wheelchair Provider Comparison

When considering power wheelchair options covered by Medicare, it's helpful to compare different providers beyond just Hoveround. Each manufacturer offers different models with varying features, and understanding these differences can help you make an informed decision.

  • Hoveround (Hoveround) - Known for compact designs that turn in their own space, making them ideal for indoor use and tight spaces. Their chairs typically feature patented Round for a Reason® technology.
  • Pride Mobility (Pride Mobility) - Offers a wide range of models from compact indoor chairs to more robust outdoor-capable chairs. Known for comfort features and customization options.
  • Invacare (Invacare) - Provides various power wheelchair models with different drive systems. Their chairs often focus on clinical positioning needs and pressure relief.
  • Permobil (Permobil) - Specializes in more advanced power wheelchairs with features like standing capabilities and advanced seating systems for complex needs.

When making your selection, consider factors like turning radius, weight capacity, battery life, and whether the chair is primarily for indoor or outdoor use. Remember that Medicare coverage will depend on medical necessity rather than brand preference, so work closely with your healthcare provider to document your specific mobility needs.

The Medicare Approval Process for Power Wheelchairs

Obtaining Medicare approval for a Hoveround power wheelchair involves several steps. The process begins with a face-to-face examination with your doctor to assess your mobility needs. During this appointment, your physician will determine if you meet Medicare's criteria for a power wheelchair and document your mobility limitations.

After the examination, your doctor will provide a written order or prescription that includes:

  • Your diagnosis and prognosis
  • A description of your mobility limitations
  • An explanation of why a cane, walker, or manual wheelchair won't meet your needs
  • Why a power-operated vehicle (scooter) isn't sufficient for your mobility needs
  • A statement that the power wheelchair is necessary for use in your home

This prescription is then sent to a Medicare-approved supplier like Hoveround, who will submit a prior authorization request to Medicare. The supplier will also conduct a home assessment to ensure your living space can accommodate the power wheelchair.

Medicare typically responds to prior authorization requests within 10 business days. If approved, your supplier will order the power wheelchair and arrange delivery. During delivery, you'll receive training on how to safely operate and maintain your new mobility device.

Costs and Financial Considerations

Understanding the financial aspects of obtaining a Hoveround through Medicare helps prevent unexpected expenses. When Medicare approves a power wheelchair, it typically covers 80% of the Medicare-approved amount after you've met your Part B deductible. The remaining 20% is your responsibility as coinsurance.

For context, power wheelchairs can range from $1,500 to over $30,000 depending on the model and features. Medicare's approved amount is often lower than the retail price, which affects your out-of-pocket costs. For example, if Medicare approves $4,000 for a power wheelchair that retails for $5,000, Medicare would pay $3,200 (80% of $4,000), and you would be responsible for $800 (20% of $4,000).

Several options exist to help with the remaining costs:

  • Medicare Supplement (Medigap) plans may cover your 20% coinsurance
  • Medicare Advantage plans might have different coverage rules and cost-sharing structures
  • Medicaid may provide additional coverage for those who qualify
  • Some nonprofit organizations offer financial assistance for medical equipment

It's crucial to verify that your supplier accepts Medicare assignment. Suppliers like Hoveround who accept assignment cannot charge you more than the Medicare-approved amount. Working with non-participating suppliers could result in significantly higher out-of-pocket costs.

Conclusion

Navigating Medicare coverage for Hoveround power wheelchairs requires understanding eligibility requirements, documentation needs, and financial considerations. By working closely with your healthcare provider to document medical necessity and choosing a Medicare-enrolled supplier, you can maximize your coverage benefits. Remember that Medicare covers power wheelchairs primarily for in-home use, and additional features may not be covered if they're not deemed medically necessary. With the right approach, Medicare can help provide the mobility solution you need to maintain independence and quality of life at home. For the most current information, always consult with a Medicare representative or healthcare provider about your specific situation.

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This content was written by AI and reviewed by a human for quality and compliance.