First-Month Purchase Option
What is the Medicare First-Month Purchase Option?
Prior to January 1, 2011, Medicare beneficiaries had the option to purchase their power wheelchairs in the first month of use, rather than just renting them. However, under the Affordable Care Act (ACA), Medicare will now only pay for the rental of power wheelchairs for the first 13 months. During this rental period, Medicare will cover 80 percent of the rental cost and the beneficiary will be responsible for the remaining 20 percent.
The option to have a wheelchair adjusted to a user's size and needs is critically important. However, with a rental that can be easily returned, suppliers are unlikely to bear the cost of needed adjustments. Without these adjustments, users are likely to suffer from exacerbated or secondary conditions that could require treatment or additional hospitalizations.
Toward the end of 2010, consumers and providers urged Congress to support a one-year delay in the elimination of the first-month purchase option under Medicare. This effort drew support from several Members of Congress, as Dear Colleague letters were circulated and signed in both the House and Senate. However, no action was taken and the elimination of the first-month purchase option for Medicare beneficiaries went into effect on January 1, 2011.
The Reeve Foundation will continue to educate policymakers on the impact that the elimination of the first-month purchase option has on Medicare beneficiaries with long-term power wheelchair needs, and will urge Congress to address the issue through legislation.