Written by SMH Occupational Therapist Cynthia Anderson
People with disabilities constitute the largest minority group in the U.S. Among the elderly, one in five people has a mobility issue. But with the right equipment, people with disabilities can live active, mobile lives.
“Mobility” is the ability to move freely and easily—and that goes far beyond being able to walk or run. It means having the freedom and independence to get to where you need or want to go. For many people with physical challenges, mobility aids are the only means for retaining that freedom.
There are many reasons that one’s mobility may be challenged: a disease such as multiple sclerosis or Parkinson Disease; an injury such as a broken hip or spinal-cord damage; a sudden change in physical status as with a traumatic brain injury or stroke; or simply that the aging process is affecting their ability to move independently.
When walking becomes too hard, dangerous, or even impossible for someone, there are a variety of mobility aids to meet their needs. These devices run the gamut from manual wheelchairs that can be customized to high-tech, electric “scooters,” and even specialty vehicles.
With so many to choose from—and insurance parameters to consider—patients often become overwhelmed with the process of getting the right mobility device. That process can be complicated and lengthy, making it imperative to find a healthcare partner who understands and can facilitate it, and who can find the best option to support the patient’s mobility goals.
Getting the Right Mobility Aid
Medicare and most insurers require that a specific evaluation and acquisition process be followed before they will cover the cost of a patient’s mobility device. Rehabilitation facilities like Sarasota Memorial’s Rehabilitation Pavilion have specialists that can help patients navigate this process, step by step.
The search for the best-suited mobility device begins with visiting a physician who supports the patient’s need for a mobility device. This appointment must be done in person, and the physician must document that he performed a “face-to-face” visit for a mobility aid and explain why the device is necessary.
The physician should also order an occupational therapy (OT) evaluation for a powered/manual mobility device. For complex mobility needs, insurance companies and Medicare require collaboration between a therapist and an assistive technology professional (ATP), who will be responsible for providing the device.
It is important that a healthcare partner prescribe the best device from the outset as Medicare and most insurers will only cover the cost of a new mobility aid every five years, unless there is a significant change in the patient’s condition.
Following the evaluation, the ATP will facilitate getting the proper documents signed by the referring physician. If the device is customized or complex, the OT also has to write an additional “Letter of Medical Necessity” to Medicare/insurance to explain why the device and its particular customizations are needed. The documents must be completed in a specific order to ensure that insurance / Medicare will pay for the aid and to avoid potential delays in the patient getting the device. Even without delays, this evaluation and ordering process can take 60 to 90 days from the initial physician’s visit.
Sarasota Memorial’s Rehab Pavilion has trained rehabilitation specialists who are well versed in mobility device assessments and custom wheelchair and seating evaluations. They can ensure that this process goes smoothly and that the best mobility device is provided in a timely manner.
SMH Occupational Therapist Cynthia Anderson has been an OT for 14 years; her primary focus is neuro-rehab. A graduate of Ohio State University, she received her masters degree in health administration in 2014 and is currently working on her doctorate in OT at Boston University.