senior in wheelchair

Does Medicare Pay for Wheelchairs?

Certain health conditions may hinder your movement, making you need a wheelchair to get more mobility. Medicare will cover the majority of the wheelchair costs if your healthcare provider providing treatment for you recommends one. The doctor’s order must state clearly that:

  • There is a health condition causing mobility issues that stops you from performing your daily activities.
  • You can safely operate the type of wheelchair you are requesting, or someone is present at home to help you use the equipment when you need it. 
  • The healthcare provider and the equipment supplier are both approved by Medicare. Medicare has a list of authorized providers. 
  • You can use the wheelchair in your home safely without the risk of accidents or injuries due to uneven floors or obstacles in the home.

What Types of Wheelchairs are Covered?

Medicare covers various types of wheelchairs. Wheelchairs are classified under durable medical equipment and are covered under Medicare Part B. They come in three basic categories: power wheelchairs, power scooters, and manual wheelchairs. The type of wheelchair Medicare will pay for depends on your health condition and your doctor’s recommendation. If you have enough strength to get in and out of a manual wheelchair, then it might be a good choice for you. You may still qualify for a manual wheelchair if you have someone at home who can assist you with getting in and out of the wheelchair. 

For temporary mobility issues, you might consider renting a wheelchair instead of buying one. Power scooters are recommended for enrollees who cannot use a manual wheelchair. Just keep in mind that your doctor needs to certify that you need a power scooter and can use one. 

For power wheelchairs, you will need to be examined in-person by a doctor. The doctor will write an order after the exam, certifying you as capable of using a power wheelchair and explaining why you need it. Before you can purchase or rent any type of wheelchair, you will also need to get authorization from Medicare. The request must be supported by the forms provided by your doctor and the medical equipment supplier. 

What are the Costs?

After you meet your deductible, Medicare Part B will cover the approved costs for a wheelchair. You’ll cover the remaining 20% plus your Medicare premiums. You may also need to cover copayment costs if you have any during doctor’s visits to get the wheelchair. In some regions, durable medical equipment suppliers participate in competitive bidding programs, further driving the costs down. Keep in mind that you can always buy a Medicare Supplement plan as well to help cover any out-of-pocket costs you may have.

Apart from Original Medicare, Medicare Part C also pays for approved wheelchair costs, though the benefits may vary from plan to plan. Wheelchairs are, however, not covered under Medicare Part D. Medicare Supplements can help you cover the coinsurance or copayment costs for wheelchairs. 

If you meet specific requirements, Medicare will cover the cost of a wheelchair. For more information, contact us today and we will make sure you understand the coverage available to you!