Coverage

Does Medicare Cover the UPWalker?

While Medicare doesn’t cover the UPWalker, it can cover other walkers, wheelchairs and additional equipment. Learn more about your Medicare coverage options, and find out how to compare plans that cover the benefits you need.

Medicare Part B covers walkers, canes, wheelchairs and other mobility devices under the coverage category of “durable medical equipment,” or DME. While Medicare does not cover the UPWalker specifically, there are other options Medicare beneficiaries may be able to consider.

Here is a review of walkers and equipment Medicare typically may cover, as well as a look at the reason why Medicare doesn’t cover the UPWalker in particular. 

What is the UPWalker?

The UPWalker is a mobility device made by LifeWalker Mobility Products. The unique design helps user stand more upright and includes a built-in seat with a backrest. The UPWalker is foldable and lightweight and comes available in several different sizes. 

Why doesn’t Medicare cover the UPWalker?

The UPWalker fits Medicare’s definition of “durable medical equipment,” so why isn’t it covered by Medicare? The reason is quite simple: LifeWalker Mobility Products does not accept Medicare reimbursement. 

Medicare defines “durable medical equipment” as “Certain medical equipment, like a walker, wheelchair, or hospital bed, that’s ordered by your doctor for use in the home.” To be classified as durable medical equipment, the item must be considered:

  • Durable (able to hold up under repeated use)
  • Medical (used for a medically necessary reason)
  • Not typically useful to someone who is not sick or injured
  • Primarily used in the home
  • Has an expected lifespan of at least three years

How Medicare coverage of durable medical equipment works

There are four basic requirements a piece of durable medical equipment must meet to qualify for Medicare coverage:

  • The item is considered medically necessary
  • The item is prescribed by a doctor
  • The item is cost effective
  • The doctor writing the prescription and the supplier of the item must be enrolled in Medicare

The UPWalker may be considered medically necessary and prescribed by a doctor. But with a retail price of more than $600 in 2021, which is several times higher than more traditional walkers, it may not meet the requirement of being cost effective.1

However, the main reason why the UPWalker is not covered by Medicare is because the supplier is not enrolled in Medicare, meaning they opt out of Medicare and don’t accept Medicare reimbursement for their services or devices. 

Suppliers of durable medical equipment and other health care providers have three options as it relates to Medicare participation. 

  1. Providers who accept assignment
    If a health care provider or equipment supplier who accepts Medicare assignment, it means they accept Medicare reimbursement as full payment for your services or items.

  2. Participating providers
    Some providers and suppliers accept Medicare insurance in general but do not accept Medicare reimbursement as full payment for their equipment or services. These providers reserve the right to charge up to 15% more than the Medicare-approved amount for your services or items. This extra charge is known as an “excess charge.”

  3. Providers who opt out of Medicare
    Some providers and device suppliers opt out of Medicare entirely and do not accept Medicare insurance.

Can the UPWalker be covered by a Medicare Advantage plan?

There are some examples of services and items that are not covered by Original Medicare (Medicare Part A and Part B) that may be covered by a private Medicare plan known as a Medicare Advantage (Medicare Part C) plan. These extra benefits may include things like prescription drug coverage, hearing, dental, vision, transportation and more. This is not the case, however, for the UPWalker. 

Providers who don’t accept Medicare are not allowed to accept Medicare Advantage plans. And because the supplier of the UPWalker has opted out of the Medicare program entirely, it will not accept a Medicare Advantage plan. 

How can I pay for an UPWalker?

The UPWalker may be paid for with a cedit or debit card, and the supplier may offers a monthly financing plan. The UPWalker may be covered by private insurance and HSA or FSA accounts, depending on the plan.

How can I find a walker covered by Medicare?

Walkers are generally covered by Medicare Part B and by Medicare Advantage plans. To find covered medical equipment and supplies like walkers, you can call to speak with a licensed insurance agent who can tell you more about Medicare Advantage plans available where you live and the benefits they cover.

Find a $0 premium Medicare Advantage plan today.

Speak with a licensed insurance agent

1-800-557-6059

Christian

About the author

Christian Worstell is a licensed insurance agent and a Senior Staff Writer for MedicareAdvantage.com. He is passionate about helping people navigate the complexities of Medicare and understand their coverage options.

His work has been featured in outlets such as Vox, MSN, and The Washington Post, and he is a frequent contributor to health care and finance blogs.

Christian is a graduate of Shippensburg University with a bachelor’s degree in journalism. He currently lives in Raleigh, NC.

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1 Price of Original UpWalker, standard, according to UpWalker.com. Price of standard walkers according to Amazon.com.