Medicare and Wheelchair Coverage
This article was updated on: 09/12/2018
If you have mobility problems and your doctor recommends a wheelchair or other device to help you get around, Medicare Part B may cover 80% of the allowable charges after you’ve met your deductible as long as you meet certain eligibility requirements.
How does Medicare coverage work with a wheelchair?
Wheelchairs are considered durable medical equipment (DME) under Medicare guidelines. Other examples of DME for mobility include walkers, canes, power scooters, and power wheelchairs. In order to qualify for Part B Medicare coverage of your wheelchair or other mobility device, you must meet the following conditions:
- Your doctor must write an order indicating that you have a medical need for a wheelchair to get around in your home (Medicare will not cover a wheelchair if you only need it to get around outside your home or for leisure and recreational activities).
- You have a health condition that limits your mobility and makes it difficult for you to move around your home.
- You need a wheelchair to help you with daily activities of living such as going to the bathroom, bathing, dressing, getting in and out of bed.
- You are physically able to safely operate a wheelchair or you have someone in the home that is always available to help you use it safely.
- Both the doctor who orders the wheelchair and the supplier who provides it must participate in the Medicare program.
Is there Medicare coverage for a power wheelchair?
In some cases, Medicare coverage is available for a power wheelchair. You must have a face-to-face exam with the doctor who is recommending the power wheelchair and he or she will have to write an order for it, explaining to Medicare why you need a power wheelchair and certifying that you are physically capable of using it.
In general, a power wheelchair may be approved if you don’t have the upper body strength to operate a manual wheelchair and you aren’t strong enough to sit up in a power scooter or operate its controls safely.
If you have mobility issues and are concerned about your health-care costs, you may want to consider a Medicare Advantage plan (Medicare Part C). Medicare Advantage plans are offered by private insurance companies approved by Medicare and are able to offer additional benefits not available under Original Medicare (Part A and Part B).
Although they must include all the coverage under Original Medicare (except for hospice care, which is still covered under Part A), most Medicare Advantage plans include Part D coverage for prescription drugs as well as coverage for routine vision, dental, and even hearing care. In many cases, copayment and deductible amounts are lower, as well.
Keep in mind that not all plan types and benefits may be available in all locations. You also need to continue paying your Part B premium, plus any additional premium required by your plan, if you enroll in Medicare Advantage.
Need more information about Medicare coverage for your wheelchair?
If you’d like to know more about Medicare and wheelchairs, I am happy to give you more information and answer your questions. If you prefer, you can schedule a phone call or request an email by clicking on the buttons below. You can also find out about plan options in your area by clicking the Compare Plans button.