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 home modifications like wheelchair ramps and bathroom grab bars.
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:
Durable medical equipment is covered under Medicare Part B medical insurance.
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:
You must meet your Part B deductible before Medicare will pay for your wheelchair or walker. In 2019, the annual Part B deductible is $185.
Medicare Part B also requires a monthly premium of $135.50 in 2019 (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.
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:
While wheelchair ramps are not covered by Original Medicare (Part A and Part B), they may be covered by certain Medicare Advantage plans (Medicare Part C).
A Medicare Advantage plans provides 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.
Most Medicare Advantage plans also offer additional benefits not covered by Original Medicare. Starting in 2019, a set of additional benefits approved for coverage by Medicare Advantage plans may include a number of “aging in place” items, such as home wheelchair ramps and bathroom grab bars. Check plan benefits to see if these services or items may be covered.
To learn more about Medicare Advantage plans and to compare plans in your area, call to speak with a licensed insurance agent today.
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