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Medicare Coverage for Wheelchairs and Scooters

If you’re enrolled in Medicare and have an injury or illness causing limited mobility, you may be covered for a wheelchair or power-operated scooter. Medicare considers these devices as Durable Medical Equipment, or DME, and will only cover these for in-home use.

How to Get Medicare to Cover Your Wheelchair or Scooter

To get started, you’ll want to schedule an appointment with your primary care doctor. Or another doctor that is currently treating you. During this face to face appointment, you’ll want to discuss all of your mobility challenges. Explain why you feel you need a wheelchair.

Being unable to do normal day to day activities inside your home, such as:

  • getting up out of the bed
  • dressing yourself
  • whether or not you’re able to use the bathroom

These are all acceptable reasons for requesting DME. It’s essential for you to communicate what limitations you’re facing with your doctor clearly. This will ensure that you’re prescribed the correct type of device.

What Wheelchairs and Mobility Scooters are Approved by Medicare?

  1. Manual wheelchair
  2. Power-operated vehicle/scooter
  3. Motorized wheelchair

Will Medicare Cover a Manual Wheelchair?

A manual wheelchair is just a traditional wheelchair that you or someone else must push. This option requires you to have the upper body strength to be able to push yourself safely. Or that you have someone available to help you safely get around the house in the wheelchair.

Will Medicare Cover a Power Operated Scooter?

If you need a power scooter because you lack the upper body strength necessary to operate a manual wheelchair, your primary care physician will need to certify that you have a medical condition limiting your mobility. Your physician will need to state that you require a power scooter to get around inside your home and perform your daily activities. You must be able to operate the scooter and its controls safely, as well as get in and out of the scooter unless you have someone that can assist you.

Will Medicare Cover a Motorized Wheelchair?

The final type of wheelchair is a motorized or electric wheelchair. If you can not operate a manual wheelchair, but you do not qualify for Medicare coverage for a power-operated scooter, you may be eligible for this option. Your doctor will need to submit this order after your face-to-face exam.

What Prior Authorization of Certain Equipment Do I Need?

You may be impacted by a Medicare program called “prior authorization.”

In this scenario, your supplier will need to:

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

What Power Wheelchairs Require Prior Authorization from Medicare?

  1. K0856: Power wheelchair, group 3 std., single power option, sling/solid seat/back,
    patient weight capacity up to and including 300 pounds
  2. K0861: Power wheelchair, group 3 std., multiple power option, sling/solid seat/
    back, patient weight capacity up to and including 300 pounds

What Will My Out of Pocket Costs Be After Medicare Pays for My Scooter or Wheelchair?

If you qualify for a power scooter, you pay 20% of the allowable charges for your equipment plus any applicable deductible. On average, the price of a motor-powered scooter is between $700-$2000, so the total cost of the scooter may vary.

Also, depending on where you live, your equipment may be subject to Medicare’s competitive bidding program. If you live in an area where this applies, you must get your scooter from a vendor contracted with Medicare under the competitive bidding program. This can result in a lower cost.

Before picking a supplier, make sure that the supplier, as well as your doctor, are both currently participating in Medicare. Then discuss your payment options and whether you should purchase or rent the wheelchair from the supplier.

Make your decision based on the length of time you will need the device. Part B only pays for a portion of the total cost on your device. Meaning there will 20% of that cost left for you to pay, out of pocket.

Does Medicare Advantage Cover Wheelchairs or Scooters?

Medicare Advantage plans are required to offer you, at minimum, the same benefits Original Medicare does, except hospice care. This means that Medicare Advantage plans must offer you the same 80% coverage on a wheelchair that traditional Medicare does. However, they’re provided by private insurance companies, and the copayments and deductibles can vary.

Will Medigap Cover the Cost of a Wheelchair or Scooter?

Medicare Supplement Plans can provide help with the additional coverage for any out of pocket costs associated with the price of a wheelchair or scooter. Since supplement plans cover the gaps in Medicare coverage, having the right plan can protect your finances.

Get Help Covering the Cost of Your Wheelchair or Scooter

The right supplement plan paired with both Medicare Part A and Part B can help pay for a wheelchair or scooter. To get help choosing the right Medigap plan, give us a call today at the number listed above. You can also compare rates online by completing our rate form here.

Lindsay Malzone

Lindsay Malzone is the Medicare expert for MedicareFAQ. She has been working in the Medicare industry since 2017. She is featured in many publications as well as writes regularly for other expert columns regarding Medicare. You can also find her over on our Medicare Channel on YouTube as well as contributing to our Medicare Community on Facebook.

19 thoughts on “Medicare Coverage for Wheelchairs and Scooters

  1. I guess I’m a little confused. You stated if it was medically necessary but also in other comments that it would have to be needed inside the home. Some people like me can manage inside the house but need a chair for outdoor use. Will Medicare help under those circumstances?

    1. Hi Phil! Yes, the wheelchair must be medically necessary and used inside the home. If the equipment is only needed outside the home, you may still be able to get it covered by Medicare. Your doctor would be best to ask.

  2. Hello,, I have group insurance through my spouse as primary. I have numerous problems my primary one pays have of s powerchair will Medicare pay secondary for my my power chair difference 2400.00 ?

    1. Hi Denise! Did you enroll in Part B or delay enrolling since you had creditable coverage through your spouses’ employer?

      1. No, I just enrolled to not be late. Medicare B has paid 2ndary. Just not sure why Hover round power chairs . priority health sends claims to Medicare after they process. Will Medicare pay secondary

      2. Yes, as long as the supplier is approved by Medicare, Part B will pay secondary.

  3. G. Anton:
    My sister is confined to a bed (due to inability to use her legs) in a CT nursing home and she is covered by both Medicare & Medicaid (Max allowable assets $1,600). They do have manual wheelchairs available: however, due to poor arm strength, she must wait for assistance to get her out of bed using a sling and someone has to push her around.
    Any idea if she would be she would be covered by either/both Medicare and/or Medicaid for a motorized chair/scooter in a nursing home? Of course she now has the Stimulus money to also help pay any additional costs. Thank you

    1. Hello! As long as your sisters’ doctor says a motorized wheelchair is Medically necessary, Medicare will cover it. I’m not sure about Medicaid, you would need to contact your local SHIP department to find out if Medicaid will also cover it. Medicaid has different rules per state.

  4. My brother has a powerchair supplied by medicare .Unfortunately the supplier fitted him for one that is too large to get through most of the doors in his home.We have tried to make it work for over a year but it is doing damage to the chair and to the doors in his home.My question is: can we sale this one so we can afford to buy another that is more suited to him?We realize that medicare will only replace chairs every 5 years.(he is a large man so I quess they thought he needed a large chair) Thank you for taking my question

    1. Hi Debra. In this scenario, I would call Medicare directly and explain the issue to see if they can help in any way. They may work with the supplier to get your brother a chair that is fitted better for his home. Make sure to have pictures of his chair including damage to the house, as well as any documentation on hand when you call them.

    1. Hello! If you meet the requirements in the article that Medicare says you must meet to qualify for a scooter, Medicare will help cover the costs. Regarding Medicaid, this depends on many other factors, including the state you live in. You would want to call Medicaid to see what your state rules are to verify if they will help cover the costs.

  5. I have COPD with complications from multiple lung cancer radiation treatments to both lungs. I’m currently on oxygen 24/7. My walking problems have to do with breathing. I currently live in an independent living section of a senior community. I can move around my studio apartment okay and do daily things there, but when it comes to walking to the dining room or to the grocery store on premises or to the pharmacy or any of the other facilities they have here for the seniors, I’m unable to make that trip without becoming breathless. Does this sound like a reason a motorized wheelchair would be covered? I have Medicare Plan A and B and I also have Medicare Supplemental Coverage Plan F.

    1. Hi Nancy, thank you for your question! A great rule of thumb to go by regarding this is the term “medically necessary.” As long as your doctor finds a motorized wheelchair medically-necessary, then Medicare will pay for it. The great news is, you have the most comprehensive coverage you can get. Your Plan F will cover all the cost-sharing left over after Medicare pays their portion of the costs. I would start by reaching out to your doctor. They will be able to start the process. I hope this helps!

    1. Hi Patricia! The rule of thumb is as long as your doctor finds it medically necessary, Medicare will help pay for it. In order to qualify, your ability to walk must be seriously compromised. You would need to have a face to face appointment when your physician and get a written prescription. I hope this helps!

  6. i need a wheelchair or scooter so i can go out and not worry about falling i asked my doctor about and he puts me off but my arthritis doctor says i need one

  7. I need a scooter to be able to go out of the house. I cannot walk without severe pain in my legs and feet due to a back injury. I also have neuropathy, fibromyalgia, arthritis and broken down feet. I cannot move well in a wheel chair and with support I can walk around the inside of my house. My house is not wheelchair accessible. Would I be eligible for a scooter under these circumstances with help from my doctor?

    1. Hello! If you’re unable to do normal day to day activities inside your home, then your doctor should be able to provide you a prescription for your scooter.


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