Medicare, Medicaid and Insurance Billing at SpinLife
Customers are advised that SpinLife, the online retail division of Numotion, does not submit claims to Medicare, Medicaid or private insurance companies. Making a purchase from SpinLife means you are waiving your right to file for reimbursement of your purchase from any government or private insurance carrier, even if the product(s) you purchase may be eligible for full or partial coverage by your health plan.
SpinLife chooses not to participate in Medicare, Medicaid or private health insurance because our goal is to provide customers with total freedom to choose the products they want and to deliver those products quickly and efficiently without a prescription or medical documentation. If you have questions about specific products or need assistance finding the right solution that fits within your budget, please call 800-850-0335 to speak with a SpinLife Product Expert. Our team may also be able to offer attractive financing options to help you manage the cost of your purchase.
Filing for Coverage or Reimbursement or Other Health Plans
SpinLife is a division of Numotion, a national provider of durable medical equipment and mobility products. While SpinLife does not participate in Medicare, Medicaid or other health plans, Numotion has other operating divisions that can submit claims to health insurance providers.
If you are interested in obtaining coverage by Medicare, Medicaid or private insurance for products offered by SpinLife, please call 800-500-9150 to reach one of NuMotion’s product experts or visit www.Numotion.com/locations to find your local branch office.
Please note that the process for obtaining insurance coverage for eligible medical equipment can take several weeks or months, and typically requires an evaluation by a licensed physician along with a prescription and other medical documentation. The types of equipment available may also be limited depending on your health plan.
Frequently Asked Questions About Insurance Reimbursement
How does Medicare coverage typically work for products offered by SpinLife?
Medicare, Medicaid and other health insurance plans require a prescription from your treating physician or practitioner, along with supporting documentation that establishes your need. This may include office notes from a visit with your physician or practitioner; physical or occupational therapy evaluations; facility inpatient or outpatient records, home health therapy notes. Specific requirements are set by the health plan and may vary depending on the equipment prescribed. Prior Authorization may also be required – the prescription and documentation is obtained and sent to your health plan for a coverage decision before the equipment can be provided.
Medicare, Medicaid and other health plans also have provisions for paying for prescribed item(s) that may only allow rental (usually under a 10 or 13 month rent-to-purchase plan if there is a long-term need) rather than initial purchase. Some items are covered only as purchases. Again, the specifics vary depending on your health plan and the type of equipment in question.
How much will I be reimbursed through Medicare if I rent or purchase eligible products?
If you work with a Numotion location to obtain equipment or supplies using your Medicare benefits, that location will discuss with you any out-of-pocket financial responsibility. In general, Medicare pays about 80% of the Medicare-established allowable for that item, less any unmet annual deductible. In most cases, Numotion will file a claim to Medicare so that Medicare will pay Numotion directly, and you will be responsible for the copay and deductible, which might be paid for you if you have a supplemental or secondary insurance plan or also have Medicaid. In some cases, Numotion may only be able to file your Medicare claim non-assigned, which means that you will pay Numotion in full, and a claim will be filed so that Medicare will reimburse you a partial amount. In those cases, we can further explain how this works when we help you with a specific request.
What is the Medicare coverage for manual wheelchairs, scooters and power wheelchairs?
Medicare covers manual wheelchairs, power-operated vehicles (scooters), and power wheelchairs as durable medical equipment (DME).
Medicare helps cover DME if:
- The doctor treating your condition submits a written order stating that you have a medical need for a wheelchair or scooter for use in your home.
- You have limited mobility and meet all these conditions:
- You have a health condition that causes significant difficulty moving around in your home.
- You are unable to do activities of daily living (like bathing, dressing, getting in or out of a bed or chair, or using the bathroom), even with the help of a cane, crutch, or walker.
- You are able to safely operate and get on and off the wheelchair or scooter, or have someone with you who is always available to help you safely use the device.
- Your doctor who is treating you from the condition that requires a wheelchair of scooter and your supplier are both enrolled in Medicare.
- You can use the equipment within your home (for example, it's not too big to fit through doorways in your home or blocked by floor surfaces or things in its path).
What is the Medicare reimbursement criteria for manual wheelchairs?
If you can’t use a cane or walker safely, but you have enough upper body strength or have someone who is available to help, you may qualify for a manual wheelchair. There has to be an established need for the wheelchair within the walls of your home.
What is the Medicare reimbursement criteria for scooters?
If you can’t use a cane or walker, and can’t operate a manual wheelchair, you may qualify for a power-operated scooter if you can safely get in and out of it and are strong enough to sit up and safely operate the controls. There has to be an established need for the scooter within the walls of your home.
What is the reimbursement criteria for Power Wheelchairs?
If you can’t use a manual wheelchair in your home, and if you don’t qualify for a power-operated scooter because you aren’t strong enough to sit up or to work the scooter controls safely, you may qualify for a power wheelchair. You must have a medical need in your home for Medicare to cover a power wheelchair or scooter. Medicare won’t cover this equipment if it will be used mainly for leisure or recreational activities, or if it is only needed to move around outside your home.
What is the Medicare reimbursement criteria for wheelchair cushions?
For wheelchair cushions, Medicare first must approve and pay for the wheelchair on which the cushion will be used. There are several types of cushions available for general use, skin protection, positioning, etc., and coverage is dependent on having a specific qualified diagnosis.
How do I submit for Medicare, Medicaid or health insurance coverage of durable medical equipment?
If you are ordering on-line or through a SpinLife representative, there is no option for submitting a claim to your health insurance. These purchases are out-of-pocket expenses and cannot be reimbursed by any insurance plan.
If you wish to seek coverage by your health plan, contact Numotion for further information. Obtaining coverage or reimbursement from Medicare, Medicaid or other health plans can be a complex process.
Numotion will gladly assist you to determine if the products you wish to obtain will be covered by your health plan and guide you through process.
If you wish to pursue Medicare, Medicaid or health insurance billing for a scooter, wheelchair, bed or other products, please call 1-800-500-9150, or contact your local Numotion branch office. Find your nearest Numotion branch office at www.Numotion.com/locations.