Medicare Coverage of Wheelchairs and Scooters


wheelchair

What It Is

Rental or purchase of a manual or power wheelchair or of a scooter, for use at home

What's Covered

Medicare Part B covers the rental or purchase of a manual or power wheelchair, or a scooter. For coverage of a power wheelchair or scooter, the equipment must be prescribed by a physician because the patient needs it to get around at home, not just when leaving home. Before a physician writes a prescription for a power wheelchair or scooter, the physician must determine what equipment is needed and whether the patient is capable of safely and effectively operating it.

If you have a Medicare Part C Medicare Advantage plan: Medicare Part C Medicare Advantage plans, also called Medicare Advantage plans, must cover everything that's included in original Medicare Part A and Part B coverage. But sometimes a Part C plan covers more, with extra services or an expanded amount of coverage. (Co-payments for Part C plans may also be different than those for Part A or Part B.) To find out whether your plan provides extra coverage or requires different co-payments for a wheelchair or scooter, contact the plan directly.

What Medicare Pays

Medicare Part B pays 80 percent of the Medicare-approved amount for the rental of this equipment. During the rental period, the supplier is responsible for maintenance and repair of the equipment. If repair is necessary, the supplier must fix the equipment at the patient's home, or pick it up and return it.

Rental payments for a wheelchair or scooter are capped at 13 months total. After 13 months of rental payments, the patient owns the equipment. Once the patient owns the equipment, Medicare Part B will pay for maintenance and servicing.

Important: Regardless of the rules regarding any particular type of care, in order for Medicare Part A, Medicare Part B, or a Medicare Part C plan to provide coverage, the care must meet two basic requirements:

  • The care must be "medically necessary." This means that it must be ordered or prescribed by a licensed physician or other authorized medical provider, and that Medicare (or a Medicare Part C plan) agrees that the care is necessary and proper. For help getting your care covered, see FAQ: How Can I Increase the Odds That Medicare Will Cover My Medical Service?

  • The care must be performed or delivered by a healthcare provider who participates in Medicare.

Was this medicareinformation helpful?

8 Comments So Far. Add Your Wisdom.

about 1 year ago

It is very difficult for a physician to fill out the paperwork properly for Medicare/Medicaid to pay for a power chair, and even more difficult for a scooter. First of all, Medicare/Medicaid do not have to make sure the person can leave the home on their own. As far as they (M/M) are concerned, a person does not need to go to the grocery store or pharmacy - they can deliver, or someone else can do it for them. It is so sad, but true. Plus there is a lot of M/M fraud, especially in the way of durable goods (chairs, scooters, canes, crutches, CPAPS, Oxygen, etc.). M/M only will provide that which allows the person to grow old IN PLACE - not necessarily be mobile on their own.


about 3 years ago

The medical equipment that Medicare will pay for


over 3 years ago

To know which Medicare plans will pay for what aspect of the use of wheelchairs & scooters. And that a physician must prescribe it's use.


over 3 years ago

I have osteoarthritis, very severe. I have so much trouble walking even with my walker. Both shoulders have rotater cuff tears so trying to move around is so very painful on many counts. My rt. knee locks and to get around without painful screaming, I have to walk very slow on my toes! I am in need of some type of power chair to be able to get around. I have never checked into a chair before but I do know that I need help. Thank you very much for anything that you can help me. Sincerely, meme


over 3 years ago

THANKS jmac_atp I TRIED DOING THAT BUT WAS UNABLE TO FIND ONE NEAR ME THAT DEALT WITH INDIVIDUALS THE ONLY ONE I FOUND DEALT WITH INSTITUTIONS ONLY. BUT I THANK YOU FOR THE INFORMATION US GAVE ME.


over 3 years ago

I WASN'T AWARE THAT YOU COULD "RENT TO OWN" SCOOTERS - IT GIVES ME 13 MONTHS TO GET UP THE EXTRA 20% THAT I WOULD HAVE TO PAY.


over 3 years ago

AMOUNTS OF COST FOR THE SCOOTERS THAT ARE COVERED BY MEDICARE - WHAT EQUIPMENT REQUIREMENTS DO THEY RATE FROM. I HAVE BEEN TOLD I QUALIFY FOR A SCOOTER BUT WAS TOLD THERE WAS A COST TO ME OF $1000 IS THAT TOO MUCH OF A CO-PAYMENT? ARE THERE SIZES AS FAR AS THE EQUIPMENT IS CONCERNED?


over 4 years ago

Please seek a certified ATP at www.resna.org. This is a site that can refer you to a credentialed professional which can aid in the funding and procuring custom wheelchairs.


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