7.3. Use of Equipment in Your Home
Use of Equipment in Your Home
- Medicare Guidelines Informaton
- Important note
- Policy Hot Spot: Learn More & Act Now!
The Home Assessment Form is a great tool to identify any accessibility issues. This tool can also help prioritize repairs. You can download the checklist below.
You May Not Know...
Medicare has very strict guidelines for coverage of DME and in particular for the subset of DME that they term "mobility assistive equipment" or "MAE". This includes canes, walkers manual and power wheelchairs and scooters (also called power operated vehicles or POVs).
Central to these guidelines is the policy that the MAE must be 'medically necessary' for use in the home and not solely for use outside the home. In other words, the device must be needed in order for you to get around your home and carry out the daily activities that Medicare has termed "mobility related activities of daily living" or MRADLs. And without the device you would be unable to carry out one or more of these activities. Medicare defines MRADLs as those daily activities that include, but are not limited to, toileting, feeding, dressing, grooming, and bathing.
Medicare does not cover an MAE device if it is needed only for use outside of the home.
You may be able to walk a litle around your home and carry out all your daily activities in your home without a walker or wheelchair, but you need the mobility device when you go out, say to the doctor's office or the grocery store or the mall. In this situation Medicare will not pay for the walker or wheelchair, since it is not needed within the home. This does not mean that you cannot use your walker or wheelchair outside of your home as well, but use outside the home cannot be your only need.