Does Medicare pay for wheelchairs?

Did you know that Medicare covers wheelchairs and scooters? That’s good news if you’re aged 65 or older — or caring for someone who is — and you’re overwhelmed by the fact that some powered wheelchairs cost upwards of $3000.

To qualify for financial assistance, the wheelchair recipient will need to be enrolled in Medicare Part B. Part B covers walkers, wheelchairs, and power-operated vehicles or scooters under a subheading called durable medical equipment (DME). Additionally, the user’s doctor will have to submit written paperwork stating that the patient has a medical need for a wheelchair or a scooter. In this documentation, the doctor must vouch for the fact that the patient has limited mobility. It must also state that the patient has a health condition that causes difficulty in movement about the home. The patient must be unable to perform basic activities like getting in out of a chair or a bed, dressing themselves, bathing, or using the bathroom without help.

The patient must be able to safely enter and exit a wheelchair, or have someone available to provide assistance at all times. The wheelchair must be of a size and configuration to be usable within the patient’s home. This means it’s not too big to fit through doorways or travel up and down ramps. Finally, the doctor who is both treating the patient’s condition and recommending a wheelchair or scooter must be enrolled in Medicare.

If all of these conditions are met, Medicare Part B will usually pay 80% of the Medicare-approved amount for a wheelchair or scooter, after the Part B deductible has been satisfied.

Choosing the right wheelchair

Many different types of wheelchairs and scooters are available. You’ll need to consult with the patient’s doctor and any associated caregivers to determine which model best fit the patient’s needs. If the patient retains upper body strength, a manual wheelchair may be the best and most economical solution. If not, the patient may qualify for a powered wheelchair or scooter. However, the patient must be able to safely operate the vehicle controls. The patient must also be able to safely enter and exit the vehicle, either by themselves or with the help of a caregiver.

The key to getting Medicare to pay for your wheelchair is to have a physician document the medical need for such a device. This almost always requires a face-to-face meeting. Keep in mind that Medicare usually will not pay for equipment that is only used outside of the home or that is only used for leisure activities. Due to high rates of Medicare fraud with respect to wheelchairs and powered scooters, you should first get a list of approved equipment suppliers. Do not buy your wheelchair from an unauthorized supplier. In some cases, you may also be able to rent your wheelchair or powered scooter equipment. Renting can result in considerable savings in the short term. Consult with your doctor or call a Medicare specialist directly at 1-800-633-4227 for further information.

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