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Medicare Part B covers wheelchairs and scooters if you need one to get around your home due to a medical condition. To ensure coverage, your doctor and the mobility equipment supplier must submit orders and documentation that meet various Medicare requirements.
To get a wheelchair, you must satisfy several conditions
Your wheelchair or scooter will be covered only if your doctor and your equipment supplier are enrolled in Medicare.
Medicare will pay most of the cost of your wheelchair or scooter if all of these conditions are met:
Your doctor submits an order stating your medical need for a wheelchair or scooter.
You have a health condition that makes it difficult for you to move around your home.
You can’t do activities of daily living — such as getting out of bed and bathing — with a cane or walker.
You’re able to safely use a wheelchair or scooter on your own, or you always have someone available to assist.
The layout of your home will accommodate a wheelchair.
Manual vs. power wheelchair or scooter
If you have sufficient upper body strength or a helper, you could qualify for a manual wheelchair.
If you can’t use a manual wheelchair, you may get coverage for a power wheelchair or scooter. To qualify, you must have an in-person exam with your doctor. If the doctor believes you require a power mobility device, they will submit an order to Medicare recommending the wheelchair or scooter and stating that you’re able to operate it.
What you pay for a wheelchair or scooter
You pay 20% of the Medicare-approved amount for mobility equipment after you pay your Part B deductible, which in 2021 is $203. Medicare pays the rest.
If you have Medicare Advantage, you might pay less. Contact the plan to learn about costs and which equipment suppliers you are authorized to use.
Depending on the type of equipment, you may be required to rent it or to buy it, or you may have a choice.
Pre-approval is required for some equipment
Some models of power wheelchairs require prior authorization — that is, Medicare must approve the purchase or rental in advance. Your equipment supplier can tell you whether you need prior authorization and should submit the required documents to Medicare.
Medicare may deny your prior authorization request if the agency believes you don’t need a wheelchair or more information is required. Ask your supplier to work with your doctor to revise the authorization request and resubmit it.