Medicare covers wheelchairs, but only certain types under specific conditions

Medicare Part B covers manual wheelchairs, motorized wheelchairs, and scooters, but only when a doctor prescribes them as medically necessary. The program does not pay for every wheelchair — it covers what Medicare calls Durable Medical Equipment (DME), which means devices meant to last and be used repeatedly at home. You typically pay 20 percent of the approved amount after you meet your Part B deductible; Medicare pays the other 80 percent.

The key requirement is a written order from your doctor stating that the wheelchair is medically necessary for your condition. Without that order, Medicare will not pay. The wheelchair must also come from a Medicare-approved DME supplier — not any medical supply store.

Coverage rules differ between renting and buying. For most people, Medicare covers rental first. If you rent for 13 months, the rental payments count toward the purchase price, and Medicare then covers the purchase. Some wheelchairs can be purchased outright from the start, depending on the type and your situation.

Key Takeaways

  • Your doctor must write a prescription stating the wheelchair is medically necessary; Medicare will not cover it without this order.
  • You must obtain the wheelchair from a Medicare-approved DME supplier, which you can find through Medicare.gov or by calling 1-800-MEDICARE.
  • Medicare typically covers rental first, and after 13 months of rental payments, you own the wheelchair and Medicare stops paying rental costs.
  • You pay 20 percent of the Medicare-approved amount after your Part B deductible; the exact cost depends on the wheelchair type and your supplier's pricing.
  • Manual wheelchairs, motorized wheelchairs, and scooters all have different coverage rules and price limits set by Medicare.

What types of wheelchairs Medicare covers

Medicare covers three main categories: manual wheelchairs (pushed by hand or by another person), motorized wheelchairs (powered by batteries and controlled by the user), and scooters (three- or four-wheeled motorized devices). Each has different coverage rules and price limits.

Manual wheelchairs are the most straightforward. Medicare covers a basic model with standard features. If you need a wheelchair with special features — like a tilt mechanism, a reclining backrest, or lightweight materials — Medicare may cover the upgrade if your doctor documents why the standard model will not work for your medical condition.

Motorized wheelchairs and scooters have stricter rules. Medicare requires that you have a condition making it impossible or unsafe to use a manual wheelchair, and that you are able to operate the motorized device safely. Your doctor must document both of these facts. Medicare also sets a price limit (called a fee schedule amount) for each type of device, which varies by region.

How to get a wheelchair covered by Medicare

The process has four steps: get a doctor's order, choose a Medicare-approved supplier, have the supplier submit paperwork to Medicare, and wait for approval.

First, see your doctor and ask for a written prescription for a wheelchair. The prescription must state that the wheelchair is medically necessary and describe the type you need (manual, motorized, or scooter). If your doctor is unsure whether Medicare will cover it, ask them to include details about your condition and why a wheelchair is necessary for your safety or function at home.

Second, find a Medicare-approved DME supplier. You can search for suppliers near you on Medicare.gov by using the DME supplier locator, or call 1-800-MEDICARE and ask for a list. Contact at least two or three suppliers to compare prices, since you will pay 20 percent of the cost yourself. Ask each supplier what their Medicare-approved price is for the wheelchair your doctor prescribed.

Third, give your doctor's prescription to the supplier you choose. The supplier will submit a claim to Medicare on your behalf, along with your doctor's order and any medical records Medicare requests. This is called a prior authorization request if Medicare needs to review it before approving payment. Some wheelchairs are approved automatically; others require review.

Fourth, wait for Medicare's decision. This usually takes one to two weeks, though it can take longer if Medicare requests more information from your doctor. The supplier will contact you once Medicare approves the claim and will arrange delivery.

Rental versus purchase: which Medicare pays for

Medicare's default is rental. When you first get a wheelchair, Medicare covers the rental cost. You pay 20 percent of the monthly rental fee; Medicare pays 80 percent (after your deductible).

After 13 consecutive months of rental payments, you own the wheelchair outright. At that point, Medicare stops paying rental costs because you no longer need to rent — you own it. This is called the rental-to-purchase agreement.

Some wheelchairs can be purchased directly without renting first. This applies mainly to certain manual wheelchairs and basic models. Your supplier can tell you whether your wheelchair qualifies for direct purchase. If it does, Medicare covers 80 percent of the approved purchase price, and you pay 20 percent.

If you need a wheelchair replaced because your old one is broken beyond repair or no longer fits your medical needs, Medicare may cover a new one. You will need a new doctor's order and must go through the approval process again. Medicare typically covers a replacement every five years, though exceptions exist if your condition changes significantly.

What you pay out of pocket

Your out-of-pocket cost depends on three things: whether you have met your Part B deductible, the Medicare-approved price for your wheelchair, and whether you are renting or buying.

You pay 20 percent of the Medicare-approved amount. If you have not met your Part B deductible for the year, you pay the full cost of the wheelchair until you reach the deductible amount, then Medicare begins paying its 80 percent share. The Part B deductible for 2024 is $240, though this amount changes yearly.

The Medicare-approved price varies by region and by wheelchair type. A basic manual wheelchair might have an approved price of $600 to $1,000, while a motorized wheelchair could be $3,000 to $6,000 or more. Call suppliers in your area to learn what the approved price is in your region. If you are renting, you pay 20 percent of the monthly rental fee for 13 months, then the wheelchair is yours and rental stops.

Some suppliers offer payment plans if your 20 percent share is more than you can pay upfront. Ask your supplier whether they offer this option.

Common reasons Medicare denies wheelchair coverage

Medicare denies wheelchair coverage most often because the doctor's order is missing, incomplete, or does not clearly state medical necessity. If your doctor writes "patient needs a wheelchair" without explaining why, Medicare may ask for more detail. Make sure your doctor's order includes your diagnosis, how the wheelchair will help you function at home, and why a manual wheelchair will not work (if you are requesting a motorized device).

Another common reason is using a non-approved supplier. If you buy a wheelchair from a regular medical supply store that is not on Medicare's approved list, Medicare will not pay for it. Always confirm the supplier is Medicare-approved before placing an order.

Medicare may also deny coverage if the wheelchair is deemed not medically necessary — for example, if you have a condition that does not significantly limit your mobility, or if the wheelchair is for outdoor use only rather than home use. Medicare covers wheelchairs for use in the home and when ready surroundings.

If Medicare denies your claim, the supplier or your doctor can file an appeal. You have the right to see the reason for the denial and to provide additional medical information supporting your need for the wheelchair.

Wheelchairs not covered by Medicare

Medicare does not cover wheelchairs used only for outdoor activities, sports, or recreation. It also does not cover specialized wheelchairs designed for specific sports, such as basketball wheelchairs or racing wheelchairs.

Wheelchairs for travel — such as lightweight folding models designed specifically for airplane trips — are not covered. Medicare covers wheelchairs for home use, not for convenience or travel.

Accessories and repairs are handled separately. Medicare covers some accessories (like cushions or safety belts) if they are medically necessary and your doctor prescribes them. Repairs to a wheelchair you own are covered if the repair costs less than 60 percent of the cost of a new wheelchair; if repair costs more, Medicare may cover a replacement instead. Routine maintenance, such as tire replacements or cleaning, is your responsibility.

Frequently Asked Questions

Do I need to use a specific supplier, or can I choose any medical supply store?

You must use a Medicare-approved DME supplier. Not all medical supply stores are approved. You can find approved suppliers on Medicare.gov or by calling 1-800-MEDICARE. Using a non-approved supplier means Medicare will not pay, even if your doctor prescribed the wheelchair.

What happens if I rent a wheelchair for 13 months and then decide I do not want it anymore?

Once you own the wheelchair after 13 months of rental, it is yours. You can keep it, donate it, or dispose of it. Medicare does not require you to return it or continue using it. If you no longer need it, you are not obligated to do anything with it.

Can Medicare cover a motorized wheelchair if I have never used a manual one?

Your doctor must document that you cannot safely use a manual wheelchair due to your medical condition. Medicare does not cover a motorized wheelchair straightforward because you prefer it. Your doctor's order must explain why a manual wheelchair is not an option for you.

If I already own a wheelchair, will Medicare pay to replace it?

Medicare typically covers a replacement wheelchair every five years. You will need a new doctor's order stating that a replacement is medically necessary. If your wheelchair is broken and cannot be repaired, or if your medical condition has changed significantly, you may be able to get a replacement sooner.

What if my doctor thinks I need a wheelchair but I am not sure?

You can ask your doctor to explain why they recommend a wheelchair and what benefits it might provide. You are not required to accept the recommendation. If you decide to pursue it, your doctor's order is the first step. If you are unsure about cost, contact Medicare-approved suppliers to learn what your 20 percent share would be before making a decision.