Types of mobility equipment covered by Medicare
Medicare Part B typically covers DME that is medically necessary for individuals at home. This includes mobility equipment like manual/power wheelchairs, mobility scooters, walkers, rollators, and more.
In all cases, the mobility equipment must be prescribed by a healthcare provider, approved via prior authorization, and the patient must be able to use the device at home. The exact coverage and out-of-pocket costs can vary widely, so it's important to confirm specifics with Medicare or a range for a wheelchair or mobility scooter healthcare provider.
Will Medicare pay for my wheelchair?
Medicare Part B often covers a manual wheelchair or power wheelchair if you have a health condition that limits mobility, and if other aids like canes or walkers are insufficient. You must be able to safely operate the wheelchair or have someone who can.
How do I receive a wheelchair through Medicare?
To get Medicare to pay for a wheelchair, your healthcare provider must first document your need for a wheelchair in your medical record. Your doctor can then submit an order to Medicare for the wheelchair, which includes diagnosis, prognosis, functional limitations, and other reasons why the equipment is necessary. This order will be sent to a Durable Medical Equipment (DME) provider that accepts Medicare.
If approved, you'll be notified and can receive your new wheelchair! Medicare Part B partially covers both manual wheelchairs and power wheelchairs, but you'll likely still pay at least 20% of the cost.
Please note that some models of wheelchair or scooter require prior authorization before purchase. Make sure to check in about medical coverage prior to purchasing a mobility device.
Will Medicare pay for mobility scooters?
Yes! Like wheelchairs, Medicare can help pay for mobility power scooters if they are deemed medically necessary.
To meet scooter benefit approval, users must be strong enough to get in/out of the scooter independently, as well as sit up and operate the controls. If not, a power wheelchair may be a better option.
However, it's important to note that Medicare will only approve prior authorization for scooters that can navigate inside of your home. Outdoor-only scooters will likely be deemed unnecessary and not approved. Medicare operates on a least costly alternative principle, so if a less expensive solution like a cane, walker, or manual wheelchair can meet the beneficiary's needs, a scooter claim could be denied.
Buying vs renting mobility equipment
Often, you can choose to either buy or rent equipment through Medicare.
When you buy, Medicare will cover the cost of the approved amount (usually 80%) after you've met your Part B deductible. The main advantage of buying is that you’re able to own the wheelchair or scooter permanently. However, the upfront costs can be higher, and you'll be responsible for maintenance and repairs.
Renting from Medicare can have lower upfront costs. Medicare will initially rent the equipment to you for a trial period, during which time it covers rental and maintenance costs.
Commonly, Medicare will rent initially rent equipment for a trial period of 13 months, during which you'll pay a monthly 20% coinsurance fee. After 13 months, ownership can be transferred directly to you.