Wheelchairs, electric wheelchairs, and mobility scooters are considered durable medical equipment and Medicare covers a portion of the cost.
If the doctor treating your condition submits a written statement that you have a medical need for a wheelchair or mobility scooter, you may be covered by Medicare Part B .
Durable Medical Equipment (DME) like a wheelchair or mobility scooter must be medically necessary. You must purchase your equipment from a Medicare-approved supplier for Medicare to cover a portion.
If you have trouble getting around and need more than a cane, walker, or crutches, Medicare may help pay for a wheelchair or mobility scooter. These items are considered Durable Medical Equipment (DME) and may be covered by Medicare Part B.
Medicare Advantage beneficiaries receive at least the same coverage but may have additional benefits and different costs than members with Original Medicare (Parts A and B).
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Like other durable medical equipment, Medicare will help cover a wheelchair if you meet certain conditions. To qualify for Medicare wheelchair coverage, you must meet all of the following requirements:
- Your doctor must state in writing that a wheelchair is medically necessary
- You have a medical condition that makes it significantly challenging to get around your home
- Your treating physician and wheelchair supplier are both enrolled in Medicare
- You’re unable to perform activities of daily living such as dressing, bathing, using the restroom, or getting in and out of bed or chairs with the help of a walker, cane or crutches.
- You can safely use the equipment in your home
If you meet all of these requirements, Part B may help cover the cost of a wheelchair. Original Medicare members can add Medicare Supplement Insurance (Medigap), which can help cover the Part B deductible and copays you need to pay for your wheelchair.
What Wheelchairs Are Covered by Medicare?
Medicare will typically cover manual wheelchairs and power-operated vehicles or mobility scooters. If you need a power wheelchair, Part B may help cover the cost to purchase or rent one. For Medicare to cover a power wheelchair, you’ll need to have a face-to-face meeting with a physician who then deems it medically necessary. [i]
Remember, no matter what kind of wheelchair you need, you’ll need to meet all the requirements above; that also includes selecting your wheelchair from a supplier that’s enrolled in Medicare. If you have any questions about eligibility, ask your doctor to make sure you’re covered. If not, you may be stuck paying full price for the cost of your equipment.
Medicare covers wheelchairs similarly to other durable medical equipment. Medicare Part B will pay 80% of the Medicare-approved cost. You’ll pay the remaining 20% after the Part B deductible is met. You may need to either rent or purchase your wheelchair, or Medicare may let you choose between the two options.
If you have Medicare Advantage (Part C), you may have different options and costs than Original Medicare members. But because wheelchairs are covered by Original Medicare’s Part B as durable medical equipment, Part C must provide at least the same level of coverage.
How Do I Get a Free Wheelchair From Medicare?
Medicare will cover 80% of the cost of your wheelchair if you meet all of the criteria listed above. That means you’ll pay the remaining coinsurance of 20%. Does Medicare pay for a wheelchair at full cost? Chances are, you’ll need to pay some portion for your wheelchair if you have Medicare. Medicare beneficiaries use the following options to help pay for items like wheelchairs and other durable medical equipment:
Charities or donated wheelchairs: Many organizations will connect you with donated wheelchairs and other equipment.
Medicare Supplement Insurance (Medigap): Helps cover out-of-pocket costs, including Part B deductibles, coinsurance and copays.
Medicare Advantage (Part C): Offers the same coverages as Medicare Parts A and B but may offer more benefits, including different pricing for wheelchairs.
How Often Will Medicare Pay for a New Wheelchair?
If you need a replacement wheelchair, discuss your options with your doctor and supplier. Typically, Medicare will pay for a new wheelchair every five years. You may be able to have Medicare cover the cost to repair your wheelchair, up to the cost of replacement. For Medicare to cover these costs, it must be repaired by a Medicare-approved supplier.
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Scooters, also called power-operated vehicles, are often covered by Medicare if you meet the requirements. But if you do qualify, how much does a motorized scooter cost? The answer depends on your needs; scooters can range in price from hundreds to thousands of dollars.
Like wheelchairs and other durable medical equipment, scooters are covered at 80% by Medicare Part B. You will pay 20%. The Part B deductible will need to be met before Medicare will begin paying its portion for your mobility scooter. If you have Medicare Advantage, you may have different coverage and pricing if you need a mobility scooter.
How Do I Get a Mobility Scooter?
A mobility scooter may be a great solution if you can’t use a cane or a walker, and can’t operate a manual wheelchair in your home.
But do you know how to get a mobility scooter with Medicare? To be eligible, you must be able to sit up and safely operate the controls and be strong enough to get in and out of the scooter. A Medicare-enrolled doctor must prescribe the mobility scooter and determine it’s medically necessary. You’ll also need to get your mobility scooter from a Medicare-enrolled supplier. If you meet all of these guidelines, Medicare may help cover your costs for the equipment.
Medicare usually pays 20% through Part B for electric wheelchairs. There are different criteria for coverage, however. Electric wheelchairs are typically reserved for those who aren’t strong enough to sit up independently or safely operate a scooter. For Medicare to help cover your eclectic wheelchair, you’ll also need to have a face-to-face exam with a Medicare-approved physician who will need to certify that it’s medically necessary.
Many electric wheelchairs also require prior authorization. This means you or your supplier will need to request prior authorization from Medicare if your equipment qualifies. If so, one of you will also need to submit the necessary paperwork to make sure Medicare covers its portion. If not, you may have to pay full price for your electric wheelchair.
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