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You might think that if you\u2019re 65 or older<\/a> and need a wheelchair or electric scooter to get around, Medicare would automatically cover it. But, as with so many areas of Medicare, things aren\u2019t quite that simple.<\/p>\n Whether Medicare will pay for the cost of a mobility device like a manual wheelchair, power wheelchair or electric scooter depends on whether you meet all its requirements.<\/p>\n \u201cIt\u2019s not the easiest thing in the world,\u201d says Diane Omdahl, author of Medicare for You<\/em> and cofounder of the Medicare advisory firm, 65 Incorporated<\/a>.<\/p>\n To clear up any confusion about terminology: a manual wheelchair is one you propel or your caregiver does; a power wheelchair (also called an electric wheelchair or power chair) is for people lacking the motor function or cardiovascular strength to operate a manual wheelchair and an electric or power scooter helps users who can\u2019t operate a manual wheelchair and can\u2019t use canes or walkers.<\/p>\n Even if you qualify for Medicare reimbursement for a mobility device, you\u2019ll be on the hook for 20% of the approved amount \u2014 your coinsurance \u2014 after paying your Part B deductible, which is $240 in 2024.<\/p>\n The first rule for Medicare coverage of a wheelchair or scooters is that you must have a medical need for one in your home.\u00a0\u00a0<\/p>\n \u201cThat doesn\u2019t mean you have to use it exclusively in your home, but that you need it in your home,\u201d says Casey Schwarz, senior counsel for education and federal policy at the Medicare Rights Center<\/a>.<\/p>\n Medicare won\u2019t cover the wheelchair or scooter if you only want the device for convenience or when traveling. Traditional Medicare also won\u2019t pay for a home wheelchair ramp.<\/p>\n The second rule for reimbursement is what Medicare calls \u201climited mobility.\u201d<\/p>\n That means having all of these:<\/p>\n Pass those tests and you\u2019ll need a face-to-face examination from a doctor (who must participate in Medicare). The physician will then submit to Medicare a Certificate of Necessity saying you have the medical need and that they are treating you for the condition.<\/p>\n You may need prior authorization from Medicare to get reimbursement for a power wheelchair, That\u2019s true whether you\u2019re in traditional Medicare or a health insurer\u2019s Medicare Advantage plan. Medicare\u2019s site has a list<\/a> of more than 40 power wheelchairs requiring prior authorization.<\/p>\n \u201cThe supplier and your health provider will submit the prior authorization,\u201d says Schwarz. \u201cIf it\u2019s denied or you need to provide more information, you can submit a new request.<\/p>\n You can either buy or rent wheelchairs and scooters. Manual wheelchairs tend to cost between $1,000 and $2,000; power wheelchairs can run well over $10,000. Electric scooters go for about $600 to $4,000. Rentals are often $100 to $400 a month.<\/p>\n Typically, if you rent a mobility device, ownership will transfer to you after 13 months.<\/p>\n Medicare won\u2019t replace a wheelchair or scooter you recently bought or began renting because you\u2019re not happy with it.<\/p>\n \u201cIf you have a chair that doesn\u2019t fit you well and you\u2019re not comfortable in it but Medicare already paid for it, they\u2019re not going to give you another one for five years,\u201d says Paul Lane<\/a>, the accessibility specialist and tech access lead for United Spinal Association\u2019s Tech Access Initiative.<\/p>\n Last year, Medicare expanded its coverage of power wheelchairs to include power seat elevation. That feature helps users reach countertops and cabinets more easily.<\/p>\n \u201cThis landmark Medicare decision to cover seat elevation is a major milestone that will improve the quality of life for so many who rely on this technology,\u201d says Chiquita Brooks-LaSure, the Centers for Medicare and Medicaid Services (CMS) Administrator in a statement.<\/p>\n You\u2019ll need an evaluation from a trained medical professional to qualify for the seat-lift benefit.<\/p>\n The Independence Through Enhancement of Medicare and Medicaid (ITEM) Coalition of groups such as the Medicare Rights Center and the United Spinal Association wants Medicare to also cover power-standing features for wheelchairs.<\/p>\n \u201cStanding wheelchairs can cut down on pressure sores and increase bowel and bladder function,\u201d says Lane.<\/p>\n CMS has said it plans to consider covering them in the future.<\/p>\n To buy or rent a wheelchair or scooter and get reimbursed by Medicare, you need to go to a durable medical equipment supplier that takes Medicare assignment. You can find ones near you on the Medicare.gov site<\/a>.<\/p>\n Don\u2019t purchase a wheelchair at a drugstore or department store just because it\u2019s convenient and you assume the store has Medicare certification. \u201cIf you go to a corner pharmacy in a remote area, I doubt they\u2019re certified,\u201d says Omdahl.<\/p>\n Be careful with nomenclature: A supplier that\u2019s Medicare-approved but doesn\u2019t take assignment<\/em> might charge you more for a wheelchair or scooter than Medicare\u2019s approved amount.<\/p>\n Medicare Advantage plans from private health insurers (the alternative to traditional Medicare) have their own networks of wheelchair and scooter suppliers as well as their own mobility-device coverage rules.<\/p>\n \u201cI found one Medicare Advantage insurer that will transfer ownership of a wheelchair to the user after 13 months, a second that will transfer certain items and one that never transfers no matter how many co-payments you make,\u201d says Omdahl.<\/p>\n Before you buy or rent a wheelchair or scooter, your doctor or the equipment supplier must visit your home to verify that you can actually use it there.<\/p>\n The durable medical equipment supplier may send a certified Assisted Technology Professional (ATP) to make the assessment and to determine the chair or scooter features you need and that Medicare will approve.<\/p>\n \u201cThey\u2019re pretty well versed. They\u2019ll say, \u2018Medicare won\u2019t pay for that. Medicare won\u2019t pay for this.\u2019 They guide you along the way,\u201d says Lane.<\/p>\n A home assessment is critically important before getting a wheelchair since some models are too wide to fit through doorways.<\/p>\n \u201cI had a chair five or six years ago and it was just huge and hard for me to get into different doorways in my home,\u201d says Lane. \u201cI would scrape up a lot of walls.\u201d<\/p>\n Omdahl recalls when she was a home care nurse helping a woman with a broken hip who got a wheelchair that didn\u2019t fit through her bedroom door. \u201cI moved the bed into the doorway and taught the woman how to stand up and hop on her bed,\u201d Omdahl says.<\/p>\n The United Spinal Association site has user reviews<\/a> of thousands of wheelchairs. You can search by model, manufacturer or type.<\/p>\n<\/div>\n\nManual wheelchairs, power wheelchairs and scooters<\/strong><\/h2>\n
Rules for Medicare reimbursement<\/strong><\/h2>\n
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Buy vs. rent<\/strong><\/h2>\n
Medicare\u2019s expanded wheelchair benefit<\/strong><\/h2>\n
Where to get wheelchairs and scooters<\/strong><\/h2>\n
Medicare Advantage rules<\/strong><\/h2>\n
Getting an assessment first<\/strong><\/h2>\n
Narrow doorway problems<\/strong><\/h2>\n