Does Medicare Pay for Wheelchairs?
If you're considering a wheelchair to improve your mobility, you aren't alone. In the US, 2 million people become new wheelchair users each year.
A wheelchair can change your life, but it'll cost you some money. That's why so many first-time wheelchair users wonder: does Medicare pay for wheelchairs? Today, we're here to answer that question.
Want to know which Medicare plan covers a wheelchair, whether you qualify for coverage, and more; then keep reading.
Does Medicare Pay for Wheelchairs?
Do you have a pre-existing condition that impacts your mobility? If the answer is yes, your doctor may deem a wheelchair medically necessary and, therefore, capable of qualifying for Medicare wheelchair coverage.
Wheelchairs and other durable medical equipment (DME) are technically considered prescriptions. That's why wheelchairs for outpatient use are covered under Medicare Part B, the Medicare prescription policy.
Medicare Part A will also cover wheelchairs. However, Part A covers inpatient health services, which means you're covered if you need a wheelchair while you're hospitalized.
Medicare Advantage plans are required to cover the same benefits as Original Medicare. That means enrolling in a private Medicare policy will get you the same wheelchair coverage as Part A and Part B Original Medicare.
Some Medigap plans can help you pay for a wheelchair even if your regular plan doesn't cover DME.
Who Can Receive Coverage?
Medicare will only pay for your wheelchair if you have trouble getting around inside your home. That means if you only have difficulty with mobility outside your home, you won't qualify for wheelchair coverage.
What Out-of-Pocket Costs Do Wheelchairs Incur?
Medicare Part B will pay 80% of the cost for your wheelchair. You must first meet your Part B deductible, though.
Which Wheelchairs Does Medicare Cover?
The type of wheelchair your Medicare plan will cover depends on your mobility level.
If you have difficulty getting around but have maintained some mobility, a manual wheelchair is for you. This is also the best option for people who only need a wheelchair temporarily.
People with very little to no mobility may qualify for a motorized or power wheelchair.
Here are the steps you'll have to take to qualify:
- Attend an office visit with your primary caregiver (PCP)
- Have your PCP verify that you can get into and out of a power wheelchair
- Have your PCP verify that you can hold yourself upright in a power wheelchair
If you meet the above criteria, your doctor will write you a prescription for a power wheelchair.
So, does Medicare pay for wheelchairs?
Yes! Medicare Part B and some Medigap plans will pay a portion of the cost for a manual or power wheelchair as long as you meet your deductible and have a doctor's prescription.
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