Does Medicare Cover Wheelchairs and Scooters?

Wheelchairs and scooters are mobility devices that can help you get around if you have a limited ability to walk.

Medicare covers different kinds of Durable Medical Equipment (DME) in different ways. Depending on the type of equipment:

• You may need to rent the equipment.
• You may need to buy the equipment.
• You may be able to choose whether to rent or buy the equipment.
• Some items become your property after you’ve made a certain number of rental payments.

Part B covers power wheelchairs and scooters only when they're medically necessary. You must have a face-to-face examination and a written prescription from a treating provider before Medicare covers a power wheelchair or scooter.

Make sure your doctors and DME suppliers are enrolled in Medicare and will accept assignment. Medicare will only pay for DME items if you get them from suppliers who are enrolled in Medicare. It’s also important to ask your suppliers if they participate in Medicare or will accept assignment of your claims before you get DME.

You may have to get prior approval (known as “prior authorization") for certain types of power wheelchairs before Medicare will cover the wheelchair cost.

Your DME supplier should:

• Request “prior authorization”
• Send the request and required documents to Medicare

You don’t need to do anything. If your physician prescribes one of these wheelchairs to you, your DME supplier will usually submit a prior authorization request and all documentation to Medicare on your behalf. Medicare will review the information to make sure that you’re eligible and meet all requirements for power wheelchair coverage. Your Medicare coverage and benefits will stay the same, and you shouldn’t experience delays getting the items you need.

Your prior authorization request may be denied if:

• Medicare finds you don’t medically require a power wheelchair
• Medicare doesn’t get enough information to make a decision

If Medicare needs additional information, your DME supplier may resubmit your prior authorization request.

After you meet the Part B deductible, you pay 20% of the Medicare-approved amount (if your supplier accepts assignment).

It’s important to ask a supplier if they participate in Medicare or will accept assignment of your claims before you get DME. If a supplier participates in Medicare, they must accept assignment (which means, they can charge you only the coinsurance and Part B deductible for the Medicare approved amount).

A non-participating provider doesn't have to accept assignment, but may choose to do so in your case. If a DME supplier doesn’t participate in Medicare or won't accept assignment, you may be charged more. For rented DME, make sure the supplier is willing to accept assignment for all rental months, otherwise you’ll have to pay the full cost of your DME upfront. If this happens, Medicare will pay you later for the amount it covers after your claims have been submitted and processed by Medicare.