What Medicare Covers When It Comes to Mobility Devices

Medicare is a federal health insurance program that helps people aged 65 and older pay for medical care and equipment. One category of items Medicare may cover is durable medical equipment (DME), which includes mobility devices. These are tools and machines that help people move around and stay independent when they have difficulty walking or moving due to injury, illness, or aging.

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Mobility devices that Medicare may cover include walkers, canes, crutches, wheelchairs, and scooters. The program also covers related items like wheelchair cushions, certain types of braces, and oxygen equipment used during movement. According to data from the Centers for Medicare & Medicaid Services (CMS), durable medical equipment represents a significant portion of Medicare Part B spending, which means many beneficiaries rely on these devices each year.

However, not every mobility device or brand falls under Medicare coverage. The device must meet specific requirements set by the government. It must be medically necessary, meaning a doctor has determined that you need it for your condition. The device must also be approved by the FDA and meet Medicare's standards for safety and effectiveness. Additionally, the device must be used in your home or outside your home for normal activities—not just for convenience or comfort.

It's important to understand that coverage rules can vary based on the type of device and your specific situation. Someone recovering from surgery might temporarily need crutches, while someone with long-term mobility challenges might need a wheelchair. Both situations could involve Medicare coverage, but the details of what's covered and how much you pay can differ significantly.

Takeaway: Medicare may cover mobility devices if they are medically necessary and meet government standards, but coverage depends on your individual circumstances and the specific device you need.

Understanding Medicare Part B Coverage for Durable Medical Equipment

Medicare Part B is the portion of Medicare that covers outpatient services and equipment. When it comes to mobility devices, Part B is typically the relevant coverage type. Part B covers about 80 percent of the cost of durable medical equipment after you have paid your deductible and met other cost-sharing requirements.

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In 2024, the Part B deductible is $240 per year. After you meet this deductible, Medicare pays for 80 percent of the approved amount for durable medical equipment, and you are responsible for the remaining 20 percent costing. This is called coinsurance. If you have a supplemental insurance plan (sometimes called Medigap) or a Medicare Advantage plan, those additional plans may help cover your coinsurance costs, but coverage varies by plan.

The equipment must be prescribed by your doctor and obtained from a supplier that is enrolled in Medicare. This is a critical requirement. If you purchase a device on your own without a doctor's order or from a non-Medicare supplier, you will likely have to pay the full cost yourself. Medicare will not reimburse you retroactively for equipment purchased without proper authorization.

There are also rules about whether you rent or purchase equipment. For some devices, Medicare may cover rental rather than purchase, especially if the device is temporary. For other devices, purchasing may be more cost-effective, and Medicare may cover the purchase price instead. The supplier and your doctor can discuss which option makes sense for your situation based on how long you are expected to need the device.

Medicare also limits how often you can receive certain devices. For example, if you receive a walker and later need a replacement, Medicare may not cover a new one for several years unless your condition changes significantly and your doctor documents that you need an upgraded model. These rules exist to prevent unnecessary spending, but they can affect your out-of-pocket costs if you need a replacement sooner.

Takeaway: Part B covers 80 percent of approved durable medical equipment costs after your deductible, but you must have a doctor's order and use an enrolled Medicare supplier to receive coverage.

How to Get a Doctor's Order for Your Mobility Device

The first step in obtaining Medicare coverage for a mobility device is getting a prescription or order from your doctor. This is not optional—it is required. Your doctor must determine that the device is medically necessary for your condition and that it will help you function better or safely in your daily life.

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During a doctor's visit, describe to your doctor the specific problems you are having with movement or mobility. For example, explain if you are experiencing difficulty walking long distances, weakness in one leg, balance problems, pain when bearing weight, or other challenges. Be specific about how these problems affect your daily activities, such as getting around your home, going to the grocery store, or visiting family. The more detail you provide, the better your doctor can understand your situation and determine what device might help.

Your doctor will conduct an examination and may ask questions about your medical history, your home environment, and your activities. Based on this information, your doctor will decide what type of device, if any, is appropriate. The doctor will then write an order or prescription that specifies the device, any special features or measurements needed, and the medical reason for the device.

Some examples of medical reasons that doctors might document include: weakness or paralysis from stroke, advanced age with balance problems, arthritis affecting weight-bearing capacity, recovering from hip or knee surgery, chronic lung disease affecting endurance, or neurological conditions affecting coordination. The doctor's documentation should clearly link your condition to your need for the specific device ordered.

If your doctor is unsure whether a particular device is right for you, he or she might refer you to a physical therapist or occupational therapist for an evaluation. These specialists can assess your mobility and recommend appropriate devices. Once a recommendation is made, the therapist can communicate this to your doctor, who can then write the order.

Takeaway: Schedule a visit with your doctor, describe your mobility challenges, and ask if a specific device might help you function better; your doctor's written order is required before Medicare coverage can begin.

Choosing a Medicare-Enrolled Supplier and Understanding Costs

Once you have a doctor's order, the next step is to obtain the device from a Medicare-enrolled supplier. These are companies that have registered with Medicare and agreed to follow Medicare rules. Using a non-enrolled supplier means you will pay the full cost of the device yourself, and Medicare will not reimburse you.

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You can find Medicare-enrolled suppliers by visiting the official Medicare website or calling 1-800-MEDICARE. The website has a searchable directory of suppliers organized by location and type of equipment. When you call or visit a supplier, inform them that you have a doctor's order and that you want the device covered by Medicare. The supplier will verify your Medicare coverage and help you understand your costs.

Your out-of-pocket costs depend on several factors: whether you have met your Part B deductible for the year, the approved Medicare amount for the device, and whether you have supplemental coverage. Here are examples of how costs might work:

  • If you have not met your $240 deductible and the wheelchair has an approved amount of $1,000, you pay the first $240 toward your deductible, then Medicare covers 80 percent of the remaining $760, which is $608. You pay 20 percent, which is $152. Your total out-of-pocket cost is $392.
  • If you have already met your deductible and a walker has an approved amount of $200, Medicare covers 80 percent, which is $160. You pay 20 percent, which is $40.
  • If you have a Medigap plan that covers coinsurance, you may pay little to nothing beyond your deductible.

It is worth shopping around among different suppliers because they sometimes offer different equipment options, service levels, and customer support. Ask each supplier about their warranty policies, repair services, and how they handle returns or exchanges. Some suppliers may offer products with additional features or customization options. Understanding what is included in the price and what services are available can help you make an informed decision.

Also ask suppliers about the equipment they have in stock and how quickly they can deliver. Some devices can be delivered within days, while others may take weeks if special measurements or customization is needed. If you need the device urgently due to a recent surgery or hospitalization, discuss timing with your doctor and supplier.

Takeaway: Search for Medicare-enrolled suppliers in your area, understand your cost-sharing responsibility based on your deductible and insurance coverage, and compare options among suppliers before making a decision