Medicare covers a new wheelchair once every five years, as long as your medical need hasn't changed and you still own the previous one.

Medicare Part B pays for a wheelchair (called a "mobility device") when a doctor says you need it for mobility inside your home. The five-year window resets from the date Medicare paid for your last wheelchair, not from when you ordered it. If your medical condition changes — for example, you move from a manual to a power wheelchair — Medicare may cover a new one sooner, but you'll need a new written order from your doctor explaining why the old one no longer meets your needs.

The coverage is not automatic. Your doctor must document that the wheelchair is medically necessary, and you must use a Medicare-approved supplier. Medicare pays 80 percent of the approved amount after you meet your Part B deductible; you pay the remaining 20 percent.

Key Takeaways

  • Medicare covers one wheelchair every five years, measured from the date of the previous purchase, not the order date.
  • Your doctor must write an order stating that a wheelchair is medically necessary for mobility in your home.
  • You must purchase from a Medicare-approved supplier; buying from any other source means Medicare will not pay.
  • If your medical condition changes significantly, a new doctor's order may allow coverage before five years have passed.
  • Medicare pays 80 percent of the approved amount; you pay 20 percent after meeting your Part B deductible.

What counts as a "new" wheelchair under the five-year rule

Medicare considers a wheelchair "new" if it is a different model, a different type (manual to power, for example), or a replacement of the same type after five years. Repairs and adjustments to your current wheelchair do not count toward the five-year limit — Medicare covers repairs and maintenance separately, with no time restriction, as long as the chair is still repairable.

If your current wheelchair is damaged beyond repair, you may be able to get a replacement before five years have passed. You will need a written statement from your supplier or repair technician saying the chair cannot be fixed, plus a new doctor's order. Medicare will review the documentation to decide whether to cover an early replacement.

How to start the process with your doctor

Ask your primary care doctor or the specialist treating your mobility issue to write a written order for a wheelchair. The order must state that you need it for mobility inside your home and describe your medical condition. Your doctor does not need to specify a brand or model — just that a wheelchair is medically necessary.

Bring this order to a Medicare-approved supplier. You can find approved suppliers by calling 1-800-MEDICARE or searching the Medicare Supplier Directory online at dmepos.cms.gov. The supplier will verify your Medicare coverage, check whether you've used your five-year benefit, and handle the paperwork with Medicare. Do not buy a wheelchair from a non-approved supplier and expect Medicare to pay — the claim will be denied.

What happens if you need a wheelchair before five years are up

If your medical condition changes — you have a stroke, your arthritis worsens, or you transition from a manual to a power wheelchair — your doctor can write a new order explaining the change. Medicare may cover a new wheelchair before five years have passed if the documentation shows your previous wheelchair no longer meets your medical needs.

The key word is "change." straightforward wanting an upgrade or a different color does not may have access to. Your doctor's note must explain why your old wheelchair is no longer appropriate for your current condition. If Medicare denies the claim, you have the right to appeal; your supplier can help you file an appeal and gather supporting medical records.

Repairs, maintenance, and replacement parts

Medicare covers repairs and maintenance on your wheelchair with no five-year limit, as long as the chair can be fixed. This includes new tires, cushions, batteries (for power wheelchairs), and other parts. You pay 20 percent of the approved amount after your deductible; Medicare pays 80 percent.

If a repair would cost more than replacing the wheelchair, your supplier may recommend a replacement instead. In that case, your doctor can request early coverage if the repair cost exceeds a certain threshold (this varies by region). Ask your supplier whether repair or replacement makes more sense for your situation and what Medicare will cover.

Renting versus buying a wheelchair

Medicare covers both rental and purchase of a wheelchair. If you rent, Medicare typically pays for up to 13 months of rental; after that, the rental cost is applied toward the purchase price, and you own the chair. Some people rent first to see whether a particular model works well before committing to purchase.

Rental is useful if you are unsure about your long-term needs or if you are recovering from an injury and may regain mobility. Purchase is usually more economical if you know you will need the wheelchair for years. Discuss both options with your supplier and your doctor; your supplier can explain the costs and help you decide which route makes sense for your situation.

What Medicare does not cover

Medicare does not cover wheelchairs used only for outdoor mobility or travel. The medical necessity must be for mobility inside your home. Medicare also does not cover specialized wheelchairs for sports, racing, or recreational use, even if you have a medical condition.

Accessories like cup holders, bags, or custom paint are not covered. However, medically necessary items like pressure-relief cushions, safety belts, or specialized seating may be covered as separate items if your doctor orders them. Ask your supplier which accessories are considered medical equipment and which are not.

Frequently Asked Questions

Can I get a second wheelchair if I need one for travel?

Medicare covers one wheelchair for mobility inside your home. A second chair for travel or outdoor use would not be covered under Medicare Part B. Some people purchase a lightweight or portable wheelchair separately for travel, but Medicare will not pay for it.

What if my wheelchair breaks down before five years and cannot be repaired?

Contact your supplier and ask them to document that the chair is beyond repair. Bring this statement to your doctor and ask for a new order explaining that your previous wheelchair cannot be fixed. Medicare will review the case; if approved, you may receive a replacement before five years have passed.

Do I have to use the same supplier for my replacement wheelchair?

No. You can use any Medicare-approved supplier. However, your new supplier will need to verify with Medicare that five years have passed since your last purchase. Switching suppliers does not change the five-year timeline — it resets from the date of your previous wheelchair, not from when you order the new one.

What if Medicare denies my claim for a wheelchair?

You have the right to appeal. Your supplier can help you file an appeal and submit additional medical documentation from your doctor. Common reasons for denial include lack of medical documentation, using a non-approved supplier, or not meeting the five-year requirement. An appeal usually takes 30 to 60 days.

Does my Medigap or Medicare Advantage plan affect wheelchair coverage?

Original Medicare Part B covers wheelchairs the same way regardless of whether you have Medigap. If you have a Medicare Advantage plan, coverage may differ — some plans cover the same amount, others may cover more or less. Contact your plan directly to ask about wheelchair coverage under your specific plan.