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UPWalker Medicare Coverage

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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 Coverage

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:

  1. Medically necessary – The walker must be needed to help you with an injury, illness, disease, or condition.
  2. Prescribed – You’ll need a prescription from a doctor or other specialist.
  3. Medicare enrolment – Both the doctor writing the prescription and the supplier of the walker need to be enrolled in Medicare and must accept assignment.
  4. 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.

The IRS has detailed info on FSAs here and a list of approved medical and dental expenses here.

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.

Amazon also sell both the UPWalker and UPWalker Lite, so it’s worth checking over there to see how their prices compare and what other deals they might have.

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.

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13 Comments

  1. My husband has Medicare, he is tall, he is 83 years young. However, he needs an upright Walker for health issues. His doctor has given him a prescription for an upright Walker. A regular Walker is not going to help him. He needs to see where he is going since he is virtually deaf. How can he get help from Medicare and humana?

    1. Hi Linda

      Thanks for your question. Unfortunately it can be quite difficult to find a supplier who will accept Medicare assignment for an upright walker. Your best bet is to first speak with your doctor and insurance provider to see if they can refer you. Otherwise the Medicare website has a list of suppliers (linked in the article above) so you can check there to see if there is one close to you.

      Hope that helps and good luck!

      Regards,

      Jim

  2. I have had three major spinal surgeries, and very severe osteoporosis of spine, and diagnosed with RA which is involving my cervical area, pinching the nerves from cervical entrance to spine. My next and final option will soon be a wheelchair, I am 74 yrs old and it is very depressing to realize my activity in life will soon be over… This UPWALKERLITE will be my last resort to standing and walking, giving me my independence for several more yrs…. Please help me find a way to cover this option to keep me on my feet. Thank you very much for your considration…Carol L Kaplan

    1. Hi Carol

      Thank you for sharing, I can only imagine what it’s like to be in your situation. Have you spoken with your doctor and insurance provider? They’ll know more about your unique circumstances and the options available to you. Good luck!

      Regards
      Jim

  3. Charles F Quinn

    I am a retired attorney at law and disabled. Suffered an Intertrochanteric fracture of the neck of the left femur.
    Surgery failed and I am left with a 3/4 inch shortening of left leg and a Sciatic nerve problem due to the injury that makes ambulation difficult. Enormously frustrated individual but INSPIRED by your commitment to getting relief for disabled seniors. Since I am one— and an experienced trial lawyer with over 800 cases tried or settled in a career
    that spanned over 50 years—I would like to be included in any further efforts on your part to assist the disabled or the handicapped. No longer in the practice of law since i am NOW in my 80s. But— the brain still works!!!! Let me know how I can be of assistance in your noble effort. CHARLIE QUINN

  4. we’re interested in the upright walker. My mother and my mother in law are dependent on some kind of apparatus to help them get around. My mother is ninety years old and has had two full knee replacements plus spine surgery and my mother in law is a few years younger and suffers, she needs knee replacements, but is afraid of surgery the problem is that they both are dependent on their SSI and/or SSA . Our question is can these uprights be purchase in payments or financed on a payment plan.

    1. Hi David

      You might want to take a look at Amazon financing offers because you may be eligible to make payments over 12 months.

      Regards
      Jim

  5. Charles F Quinn

    Dave Villegas speaks of whether or not the Upright lite can qualify as a DME under MEDICARE law.
    Theoretically YES. It meets all the DME legal requirements but the “fly in the ointment” is this>>>your
    vendor must be “qualified” as a vendor that meets Medicare requirements. That’s where they get you. My
    vendor never met Medicare’s stringent and sometimes silly requirements and thus I got screwed and I am
    a lawyer with deep experience in disability law as well as DISABLED MYSELF now that I am in my 80s.
    Go with a financing deal via AMAZON’S CREDIT card. You cannot do better and will not do better.
    Good luck. Charlie Quinn (retired Atty-at-law)

    1. Thanks Charlie – yup Amazon’s credit card looks to have some good financing options that could help a lot of people!

  6. I have pers. from both my ortho and pc for walker , but haven’t been able to find someone to order it for me. in Louisville ky. 77 yr old with multiple problems. thank you

    1. Hi Brenda – unfortunately right now it’s not looking like the UPWalker is going to be available via Medicare anytime soon.

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