Medicare will now cover elevating power wheelchair seats
by Ranae Beeker, RN
A great example of the truth of this statement took place over the last several months, right within our FSHD community. We learned that Medicare initiated a process to receive comments and stories answering the question: “Why” should an elevated seat on a power wheelchair be paid for by Medicare dollars?
Using Medicare’s own criteria for coverage, you demonstrated how elevating seats enhance both the safety and quality-of-life aspects of power wheelchairs, which are already covered. You emphasized how it affects individuals in their homes, as currently this is a strong focus of Medicare reimbursement. And while usage at home is the primary concern of Medicare, we know that elevating seats are just as useful outside of the home as well: promoting safety, socialization, and independence.
Our community shared with Medicare that elevating power wheelchair seats meet key needs:
- Functions that are important to our activities of daily living.
- toileting, bathing, getting in and out of bed, dressing… cooking and working in the kitchen.
- Social Functions: Having a conversation with someone at eye level or shaking their hand, an important source of human dignity and relationship building
- Enhancing the scope of reachability: countertops, appliances, drawers and more could now be within reach.
- Safety: Elevating seats promote safe and stable movement inside the home and without.
According to a Medicare Policy expert, this National Coverage Determination (NCD) goes into effect immediately. In theory we could submit a claim for a seat elevation system today and the process of getting set up for this important need would start. That being said, please remember the wheels of government move slowly. This NCD, once signed, needs to go to the states to implement in terms of reimbursement rates….so, the reality is that there will be some lag time for the state to get to your claim, but in overall terms of coverage, we should be all set now, to initiate a request for a seat elevator in a new power wheelchair.
Thank you to our wonderful FSHD community for helping to make this essential coverage a reality! We truly are stronger together, and we should take heart from this example of what our community can help accomplish.