Does Medicare Pay for Wheelchairs and Walkers?

Original Medicare (Part A and Part B) does cover wheelchairs and walkers, though there are certain restrictions and guidelines you should know about.

These items are categorized as “durable medical equipment” (DME) and are covered by Medicare Part B.

Medicare Advantage (Part C) plans also cover wheelchairs, walkers and other durable medical equipment. Some Medicare Advantage plans also cover other benefits not found in Original Medicare. 

What equipment does Medicare pay for?

Medicare covers durable medical equipment if it is reusable – such as wheelchairs and walkers – and if your doctor prescribes it as medically necessary for use in your home.

In order for Medicare to pay for your wheelchair or walker, it must meet the following requirements:

• Only manual wheelchairs qualify as durable medical equipment. Power wheelchairs are only covered by Medicare when determined to be medically necessary (such as when the beneficiary is unable to operate a manual wheelchair).
  
  
• Depending on the circumstances, you may be required to either purchase the equipment or rent the equipment. In some situations, you may be given the choice to either purchase or rent.
  
  
• The use of a wheelchair or walker must be considered medically necessary and prescribed by a doctor.
  
  
• The wheelchair or walker must be appropriate for use in the home (although it may also be used outside of the home as well).
  
  
• The wheelchair or walker must be considered “durable,” or able to withstand repeated use and likely to last for three years or more.  
  
  
• The item must serve a medical purpose.

Durable medical equipment is covered under Medicare Part B medical insurance.

How much do wheelchairs and walkers cost with Medicare?

If the supplier of your wheelchair or walker accepts Medicare assignment, you will typically pay 20 percent of the Medicare-approved amount of the cost of the device.

The Medicare-approved amount is the amount that Medicare has declared it will pay the supplier in exchange for the item. The 20 percent share that you are responsible for is your Medicare Part B coinsurance.

Each supplier of durable medical equipment falls into one of three categories:

• If you receive the wheelchair or walker from a “participating” supplier, they must accept the Medicare-approved amount as full payment.
  
  
• If they are enrolled in Medicare but are not a participating provider, they have chosen to supply equipment to Medicare beneficiaries but do not accept the Medicare-approved amount as full payment. They can charge up to 15 percent more than the Medicare-approved amount, a cost that is known as an “excess charge.”
  
  
• If a supplier does not accept Medicare and are not enrolled in Medicare, the item will not be covered and there is no limit to what they may charge you.

You must meet your Part B deductible before Medicare will pay for your wheelchair or walker. In 2023, the annual Part B deductible is $226.

Medicare Part B also requires a monthly premium of $164.90 in 2023 (although higher-income earners may have to pay more).

The Part B deductible, coinsurance and excess charges may be covered by certain Medicare Supplement Insurance plans.

What other mobility equipment is covered by Medicare?

Wheelchairs and walkers are not the only items designed to help with mobility that are covered by Medicare. Similar items that may qualify as durable medical equipment and can be covered by Medicare include:

• Rollators
• Power scooters
• Crutches
• Canes
• Patient lifts
• Therapeutic shoes or inserts for people with severe diabetic foot disease
• Prosthetic legs
• Leg braces

Medicare Advantage plans cover wheelchairs and walkers

Medicare Advantage plans provide all the same basic benefits as Original Medicare, which means that Medicare Advantage plans cover wheelchairs and walkers the same way that Original Medicare does.

Medicare Advantage plans can also offer additional benefits not covered by Original Medicare. 

To learn more about Medicare Advantage plans and to compare plans in your area, call to speak with a licensed insurance agent today.

Or call 1-800-557-6059 1-800-557-6059 TTY Users: 711 to speak with a licensed insurance agent. We accept calls 24/7!

About the author

Christian Worstell is a senior Medicare and health insurance writer with MedicareAdvantage.com. He is also a licensed health insurance agent. Christian is well-known in the insurance industry for the thousands of educational articles he’s written, helping Americans better understand their health insurance and Medicare coverage.

Christian’s work as a Medicare expert has appeared in several top-tier and trade news outlets including Forbes, MarketWatch, WebMD and Yahoo! Finance.

Christian has written hundreds of articles for MedicareAvantage.com that teach Medicare beneficiaries the best practices for navigating Medicare. His articles are read by thousands of older Americans each month. By better understanding their health care coverage, readers may hopefully learn how to limit their out-of-pocket Medicare spending and access quality medical care.

Christian’s passion for his role stems from his desire to make a difference in the senior community. He strongly believes that the more beneficiaries know about their Medicare coverage, the better their overall health and wellness is as a result.

A current resident of Raleigh, Christian is a graduate of Shippensburg University with a bachelor’s degree in journalism.

If you’re a member of the media looking to connect with Christian, please don’t hesitate to email our public relations team at Mike@tzhealthmedia.com.

 

 

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