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Medicare will often pay for most of the cost of a wheelchair or electric scooter if you qualify. Your doctor will need to verify that you need a wheelchair or scooter to get around your house.
Before you get started, make sure that your wheelchair supplier doesn't charge more than the Medicare-approved price to avoid paying extra costs.
Does Medicare cover wheelchairs?
Medicare covers wheelchairs if your doctor decides you need help getting around your house. You must meet the following requirements for Medicare to pay for your wheelchair or scooter.
- You're unable to move around your home because of a medical condition.
- You can't do daily activities like getting dressed or bathing by yourself.
- You can safely use your wheelchair, or you have someone who can help you use it.
Either your doctor or wheelchair supplier must also visit your home before you can be approved for a wheelchair or scooter. They'll make sure that you can use your equipment inside your house. For example, a doctor may deny you Medicare coverage if your doorways are too narrow for a wheelchair to get through.
It's important to remember that not all doctors and suppliers accept Medicare. Even if a doctor or supplier works with Medicare, they may not accept the price Medicare is willing to pay. Ask your doctor and wheelchair provider if they "accept assignment," which means they won't charge you an extra cost beyond what Medicare will pay.
Medicare doesn't cover equipment that's mainly needed for getting around outside the home. That means Medicare will not pay for a wheelchair if you can walk short distances inside your home without trouble.
Your doctor will also decide whether you need a motorized or nonmotorized wheelchair. That means you won't get a motorized wheelchair unless you can't use a regular wheelchair and you don't have help in your home, such as a family member, friend or home health aide.
How often will Medicare pay for a wheelchair?
Medicare only pays to replace your wheelchair or scooter once every five years, except in a few special circumstances. The most notable one is if your wheelchair no longer works and cannot be repaired. You can only get one wheelchair or scooter through Medicare at a time, and you may be responsible for day-to-day routine maintenance.
However, Medicare pays for wheelchair and scooter repairs. It also covers replacement batteries.
Are mobility scooters covered by Medicare?
Mobility scooters are covered by Medicare. But your doctor must visit your home first to verify that you can move around your house without running into too many obstacles, such as cluttered rooms and narrow doorways and halls.
Your doctor will approve you for the cheapest mobility equipment that fits your needs. That means you may not be eligible for a mobility scooter if you can operate a regular wheelchair since those are cheaper.
Your doctor will also make sure that you're able to sit upright in your scooter, and that you can safely maneuver the equipment.
Does Medicare cover knee scooters?
Original Medicare does not pay for knee scooters. Although Medicare covers the cost of buying or renting many types of "durable medical equipment" (DME), knee scooters do not meet Medicare Part B coverage requirements since crutches can accomplish a similar function at a lower price.
However, some Medicare Advantage plans may pay for some or all of the cost of a knee scooter. Medicaid may cover knee scooters if you dual qualify for both programs.
How much does Medicare pay for scooters and wheelchairs?
Medicare will pay for 80% of the cost of a wheelchair, after you pay a $226 Part B deductible. You're responsible for paying the remaining 20%, which is known as your coinsurance.
Wheelchairs can cost as little as a few hundred dollars for a basic nonmotorized model and as much as several thousand dollars for more expensive motorized wheelchairs. Mobility scooters can similarly run from less than $1,000 to $4,000 or more.
A 20% coinsurance on a $4,000 mobility scooter would cost you $800 in out-of-pocket costs after you've met your annual deductible.
How to get a wheelchair through insurance
Most private health insurance plans cover wheelchairs, although you may run into restrictions similar to what you'd find with Medicare coverage.
If you have both Medicare and private health insurance, your private insurance will usually pay out before Medicare does. Like Medicare, most private medical insurance policies require a doctor's approval before coverage kicks in.
You may have to pay for your wheelchair yourself and request reimbursement later if you have a group health plan through your job or your spouse's work. This could mean waiting several months for an insurance payout.
Frequently asked questions
Does Medicare pay for wheelchairs and scooters?
Yes, Medicare will pay for most of the cost of a wheelchair or scooter if your doctor has decided you need one to get around your home. Medicare covers 80% of your costs after you've paid your $226 Part B deductible.
How can I find Medicare-approved scooters near me?
How often will Medicare pay for a mobility scooter?
Medicare will pay for a new mobility scooter or wheelchair once every five years. You may receive a new scooter or wheelchair earlier if your existing equipment breaks down and the repair costs are higher than the replacement costs.
Information for wheelchair and scooter eligibility requirements came from Medicare.gov.