What It Is
Rental or purchase of a manual or power wheelchair or of a scooter, for use at home
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.