Covering the bases: Normal wear won't get a new wheelchair | Maryland Gazette (HometownGlenBurnie.com)

Your wheelchair falls in the Medicare category of durable medical equipment. Medicare guidelines state that the reasonable useful lifetime requirement for durable medical equipment is determined by the Medicare contractor, but in no case can it be less than five years. The reasonable lifetime requirement for your wheelchair is based on when the chair was delivered to you. If you don't know this date, you can call Medicare at 800-633-4227 to find out.

Replacement during its useful lifetime of five years would be covered by Medicare only if the chair was lost, irreparably damaged, or if your medical condition changed and the chair no longer met your medical needs.

Medicare makes a clear distinction between irreparable wear and irreparable damage. Irreparable damage is caused by a rare and unexpected event, which damages the medical equipment beyond repair. Irreparable wear is deterioration of an item due to day-to-day usage.

In the meantime, you can contact Senior Information and Assistance at the Department of Aging to see if you can get help finding a used wheelchair in better condition than your current wheelchair.

When your chair reaches the five-year mark, you will need to have an order and a Certificate of Medicare Necessity from your physician to take to a durable medical equipment supplier to get a new chair. Be sure you check with the supplier to make sure they are a Medicare participating provider, which will make the paperwork much, much easier for you.

What is a Medicaid spend-down? I've been told that my mother can qualify for help paying her nursing home costs if we apply for this program, but I don't understand how it works.

A Medicaid spend-down is a state program for people whose income and assets are higher than would normally qualify them for Medicaid.

Medicaid is another term for Medical Assistance. A spend-down helps those with high medical expenses who reduce their income and assets to the Medicaid eligibility level.

The local Department of Social Services can help you apply for this program for your mother. You can start this process by gathering all of your mother's income and asset information for the past five years.

Susan Knight is a senior health insurance consultant. If you have questions about the information in this column, contact the county's Senior Health Insurance Program at the Department of Aging and Disabilities at 410-222-4464 or ship_program@aacounty.org.