Paralyzed Ivan Vargas becomes first person on East Coast to receive the $91,032 Ekso Indego exoskeleton under revised Medicare 2024 ruling

Ivan Vargas has become the first person on the East Coast to receive the Ekso Indego Personal exoskeleton under the revised Medicare 2024 Home Health Rule. He experienced a spinal cord injury during home remodeling, which resulted in paralysis from the waist down. With the exoskeleton, Ivan can now walk about rather than use a wheelchair.

The 29-pound (13 kg) Ekso Indego uses motors to flex the legs at the knees and hip while walking. Users lean forward to stand and walk, lean back to sit, and stand upright to stop the exoskeleton. The iOS smartphone app allows users to adjust speed and step height settings, track performance, and export reports. The device can be used to walk across asphalt, carpet, grass, and other flooring surfaces and can be worn or taken off while seated.

Medicare now classifies exoskeletons in the braces category, allowing these devices to be prescribed to qualifying patients for home use. This 2024 rule change allows Medicare to reimburse patients up to $91,032 for an exoskeleton, but they are still responsible for the mandatory 20% copay. Ekso Bionics president Scott Davis has stated, “We’re prepared to offer our Ekso Indego Personal at the proposed Medicare payment level, so we can get this out to as many folks [as] need it.” Veterans can obtain one free through the VA Hospital.

Qualifying users must have a spinal cord injury from T3 to L5, be over 18 years old, and be fit enough to use the Indego. A mandatory three- to six-month training program to ensure safe usage must be completed before home use is allowed. Readers who want to avoid spinal cord injuries while working on their roofs should wear a properly-secured safety harness (like this one on Amazon).

Only Ekso Bionics and Lifeward (formerly ReWalk) exoskeletons currently have FDA approval for home use and qualify for Medicare reimbursement. Neither is self-balancing, unlike the Wandercraft exoskeleton showcased during the 2024 Paris Olympics by paralyzed Kevin Piette while carrying the Olympic Torch. Because of this, a designated support person must accompany the patient during Ekso Indego exoskeleton training and walks for safety.

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