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One of the most frequent questions I get asked is whether Medicare covers the UPWalker. This is understandable because both the UPWalker and UPWalker Lite are costly and frankly out of the reach of most seniors. Here’s what my research uncovered.
NO, unfortunately at the time of writing the UPWalker is not covered by Medicare. The UPWalker is sold as a cash-pay product and the current suppliers are not enrolled in Medicare, so it does not qualify for reimbursement.
But don’t let that take the wind out of your sails. There may be other ways you can get an upright walker either covered by insurance or at a steep discount. Read on to learn exactly why Medicare does not yet cover the UPWalker and the other options you may have.
UPWalker Medicare FAQ
Is the UPWalker covered by Medicare?
No, as mentioned above the UPWalker and UPWalker Lite do not qualify for Medicare coverage. While they classify it as Durable Medical Equipment, and your doctor can prescribe it, because the suppliers do not accept Medicare assignment you are unable to get Medicare to pay for it.
Why Medicare will not pay for an UPWalker
To understand why Medicare will not help pay for the UPWalker, we need to take a quick look at the Medicare Part B (Medical Insurance) rules covering walkers and other Durable Medical Equipment.
There are four basic conditions you must meet to get an upright walker covered by Medicare:
- Medically necessary – The walker must be needed to help you with an injury, illness, disease, or condition.
- Prescribed – You’ll need a prescription from a doctor or other specialist.
- Medicare enrolment – Both the doctor writing the prescription and the supplier of the walker need to be enrolled in Medicare and must accept assignment.
- Cost effective – The walker must be deemed to be cost-effective.
So let’s take a look at the UPWalker and how it fits into these rules.
Number 1 and 2 are not a problem because the UPWalker can certainly be considered medically necessary and you can get your doctor to prescribe one for you.
Number 3 is an issue because right now we have not found any suppliers who accept assignment from Medicare. (Accepting assignment means they have agreed to be paid by Medicare rather than directly by the customer.)
Number 4 may also be an issue because the cost of the UPWalker might mean it does not pass the cost effective test. This would likely be looked at on a case-by-case basis.
Does Medicare pay for other stand up walkers?
Possibly. While there is nothing stopping any stand up walker that meets the criteria of Durable Medical Equipment from being covered by Medicare, the challenge is finding a supplier who accepts Medicare assignment.
Where can I get a walker covered by medicare?
The official Medicare website has an approved supplier directory which you can find here. Simply type in your zip code on that page and they will show you the closest Medicare approved walker suppliers.
Is the UPWalker Durable Medical Equipment?
Yes, the UPWalker passes the Durable Medical Equipment (DME) test.
According to Medicare.gov, to be classified as DME it must meet the following five criteria:
- Durable – strong enough to hold up under repeated use
- Medical – used for a medically prescribed reason
- Sick / Injured – not generally useful for those who are not sick or injured
- Home – used primarily in your home
- Lifetime – has an expected lifetime of at least three years
The UPWalker ticks all of these boxes and therefore it is classified as Durable Medical Equipment.
UPWalker Insurance Info
Does insurance pay for an UPWalker?
Possibly. Because there are so many different insurance plans it’s impossible to say if yours will cover the UPWalker or not. Contact your insurance provider to check the specific details of your policy.
Will my Flexible Spending Account (FSA) cover the UPWalker?
Flexible spending arrangements generally do include medical equipment items such as walkers, wheelchairs, crutches, and canes. And because you don’t pay taxes on the money you put into this account, it’s like getting a saving of whatever taxes you would have otherwise paid on that money.
Remember, FSA funds must be spent within the plan year. And they can be used for yourself, your spouse if you’re married, and your dependents.
Get an UPWalker Without Insurance
How much does the UPWalker cost without Medicare?
According to the manufacturers website, the RRP of the UPWalker is as follows:
- Standard UPWalker (H200) $645
- Small UPWalker (H200-S) $645
- Large UPWalker (H200-L) $695.00
- UPWalker Lite $545
Prices are correct as of 9th October 2019.
What alternatives are there to the UPWalker?
The price of the UPWalker does put it out of the reach of many people. Luckily there are a number of new upright walkers on the market that are much more cost effective. The two most well-received walkers we have reviewed are the Elenker Upright and the Beyour Walker.