Medicare covers motorized wheelchairs, but only certain models and only when a doctor says you need one for mobility inside your home

Medicare Part B covers motorized wheelchairs (called power wheelchairs) and motorized scooters under the category of Durable Medical Equipment, or DME. The program pays 80 percent of the approved amount after you meet your Part B deductible. You pay the remaining 20 percent, plus any amount the supplier charges above Medicare's approved price.

The catch is that Medicare has strict rules about which wheelchairs it will pay for. Your doctor must document that you cannot walk or propel a manual wheelchair safely, and that you need the motorized version specifically to move around inside your home. Medicare will not pay for a wheelchair meant mainly for outdoor use or travel, and it will not pay for upgrades or add-ons beyond what it considers medically necessary.

The entire process — from your doctor's order to receiving the wheelchair — typically takes four to eight weeks. During that time, you will work with a Medicare-approved DME supplier, not directly with Medicare.

Key Takeaways

  • Your doctor must write an order stating that you cannot walk or use a manual wheelchair and that a motorized wheelchair is medically necessary for movement inside your home.
  • Medicare pays 80 percent of the approved amount after your Part B deductible; you pay 20 percent plus any amount above the approved price.
  • You must use a Medicare-approved DME supplier; ordering from a non-approved supplier means Medicare will not pay anything.
  • Medicare covers one motorized wheelchair per five years, so replacement is limited unless your medical condition changes significantly.
  • Motorized scooters follow the same rules as power wheelchairs, but Medicare treats them as a separate category with its own approval process.

What your doctor needs to document before Medicare will consider payment

Your doctor cannot straightforward write "patient needs a motorized wheelchair." Medicare requires specific medical documentation. The doctor must state in writing that you have a condition that prevents you from walking or safely propelling a manual wheelchair, and that the motorized wheelchair is medically necessary for you to move around inside your home.

Common conditions that support this documentation include severe arthritis, advanced Parkinson's disease, spinal cord injury, muscular dystrophy, and post-stroke paralysis. The key is that the condition must genuinely prevent manual propulsion — not just make it uncomfortable or tiring. Medicare reviewers will examine the medical record to confirm the diagnosis matches the need.

Your doctor will also need to note your current mobility status: whether you can walk at all, how far, and with what information. If you use a cane, walker, or manual wheelchair now, the doctor should explain why those are no longer sufficient. This documentation becomes part of the order that goes to the DME supplier.

How to find a Medicare-approved DME supplier and place an order

You cannot order a motorized wheelchair from any company and expect Medicare to pay. The supplier must be enrolled with Medicare and approved to dispense DME in your state. You can search for approved suppliers on the Medicare DME Supplier Directory at dmepos.cms.gov, or call 1-800-MEDICARE to get a list of suppliers near you.

Once you have your doctor's order, contact the supplier directly. Bring or send them the written order, your Medicare card, and any other documents they request. The supplier will verify your coverage, check that your deductible status, and give you an estimate of what you will owe. They will also submit the order to Medicare for review.

Do not assume the first supplier you find is the best. Call at least two or three approved suppliers and compare their prices, delivery timelines, and whether they offer in-home fitting and adjustment. Some suppliers are faster than others, and some charge less for the same wheelchair model.

Medicare's approval process and what can delay or deny your order

After the supplier submits your order, Medicare sends it to a Durable Medical Equipment Regional Carrier, or DMERC. The DMERC reviews the doctor's documentation to confirm it meets Medicare's medical necessity rules. This review typically takes one to two weeks.

Common reasons Medicare denies motorized wheelchair orders include: the doctor's documentation does not clearly state that you cannot walk or propel a manual chair; the condition listed does not typically require a motorized wheelchair; or the order is for a scooter when a power wheelchair would be more appropriate (or vice versa). If Medicare denies the order, the supplier will notify you and your doctor, and you have the right to appeal.

If Medicare approves the order, the supplier will contact you to schedule delivery and fitting. The entire process from doctor's order to delivery usually takes four to eight weeks, though it can be faster if the DMERC has a short backlog.

What Medicare pays and what you owe out of pocket

Medicare's approved amount for a motorized wheelchair varies by region and model, but typically ranges from $4,000 to $6,000. After you meet your Part B deductible (which is $226 in 2024, though this amount changes yearly), Medicare pays 80 percent of the approved amount. You pay the remaining 20 percent.

If the supplier charges more than Medicare's approved amount, you are responsible for the difference. For example, if Medicare approves $5,000 and the supplier charges $5,500, Medicare pays $4,000 (80 percent of $5,000), and you owe $1,500 ($1,000 as your 20 percent share, plus the $500 overage). This is why comparing supplier prices matters.

If you have a Medigap or Medicare Advantage plan, your out-of-pocket costs may be lower. Medigap plans often cover the 20 percent coinsurance. Medicare Advantage plans vary — some cover DME the same way Original Medicare does, others cover it differently. Check your plan documents or call your plan before ordering.

Coverage limits: how often Medicare will pay for a replacement

Medicare covers one motorized wheelchair per five-year period. If your wheelchair breaks down or becomes unusable before five years have passed, Medicare will not pay for a replacement unless your medical condition has changed significantly enough that your doctor documents a new medical need.

If your condition does change — for example, you lose more mobility or develop a new condition that requires a different type of wheelchair — your doctor can write a new order and you can go through the approval process again. The DMERC will review the new documentation to determine whether the change in condition justifies an earlier replacement.

Repairs and maintenance are handled differently. Medicare does not cover repairs to a wheelchair you already own. If your wheelchair needs fixing, you pay out of pocket or contact the manufacturer's warranty. Some suppliers offer repair services for a fee.

Motorized scooters: different rules and approval process

A motorized scooter (also called a power scooter or mobility scooter) is not the same as a power wheelchair in Medicare's eyes, and the approval rules are stricter. Medicare covers a scooter only if you can transfer on and off it independently, can operate the controls, and can use it safely indoors. If you cannot meet these requirements, Medicare will not pay, even if your doctor prescribes one.

Additionally, Medicare requires that you have already tried a cane or walker and found it insufficient before approving a scooter. The doctor's order must document this trial period. For a power wheelchair, this prior trial is not required — the doctor straightforward needs to state that you cannot propel a manual chair.

Scooters are also subject to the same five-year replacement limit and the same 80/20 cost split as power wheelchairs. The approved amounts are typically similar, though some scooter models are more expensive.

What to do if Medicare denies your order or if you disagree with the decision

If the DMERC denies your order, the supplier will send you a notice explaining the reason. You have the right to appeal. The first step is to ask your doctor to review the denial letter and provide additional documentation if possible — for example, a more detailed explanation of why you cannot use a manual wheelchair, or test results that support the medical necessity.

Send the additional documentation to the supplier, who will resubmit it to the DMERC for reconsideration. This is called a redetermination and must be requested within 120 days of the denial. If the DMERC denies the redetermination, you can appeal further to an independent review contractor, and then to an administrative law judge if needed. These later appeals are more complex and may benefit from help from a patient advocate or legal aid organization.

Frequently Asked Questions

Can I buy a motorized wheelchair myself and ask Medicare to reimburse me?

No. Medicare will only pay if you order through a Medicare-approved DME supplier. If you buy a wheelchair on your own, Medicare will not reimburse you, even if it is the exact model Medicare would have approved. Always get your doctor's order and work with an approved supplier first.

Does Medicare cover motorized wheelchairs for outdoor use or travel?

No. Medicare covers motorized wheelchairs only for movement inside your home. If you need a wheelchair for outdoor terrain or long-distance travel, you would have to pay out of pocket. Some people have both — a Medicare-covered indoor chair and a separately purchased outdoor scooter.

What if my doctor says I need a motorized wheelchair but I do not want one?

You do not have to accept a motorized wheelchair even if your doctor recommends it. However, if you later change your mind and want one, you will need a new doctor's order. Medicare will not pay for a wheelchair ordered in the past if you declined it at the time.

Can I upgrade to a fancier model or add special features?

Medicare covers the basic motorized wheelchair model that meets your medical needs. Upgrades — such as a lighter frame, specialized seating, or advanced control systems — are your responsibility. The supplier can tell you the Medicare-approved model and the cost of any upgrades you want to add.

What happens if my wheelchair is damaged in an accident?

Damage from an accident is not covered by Medicare. You would need to file a claim with your homeowner's or renter's insurance if the accident occurred at home, or with the at-fault party's insurance if someone else caused the damage. Manufacturer defects are usually covered under warranty.