Medicare covers mobility scooters, but only under specific conditions

Medicare Part B covers a mobility scooter (also called a motorized scooter or electric scooter) if your doctor prescribes it as medically necessary and you meet Medicare's requirements. Medicare does not pay for scooters you buy on your own or use for convenience. The scooter must be prescribed by a doctor, ordered through a Medicare-approved supplier, and you must have a face-to-face doctor visit within the past six months where your mobility need was documented.

Medicare pays 80% of the approved amount after you meet your Part B deductible. You pay the remaining 20%. If you have a Medigap or Medicare Advantage plan, your out-of-pocket cost may be lower depending on your plan's coverage.

Key Takeaways

  • Your doctor must prescribe the scooter and document that you cannot walk 150 feet without stopping to rest, or that walking poses a safety risk.
  • You need a face-to-face doctor visit within six months before the prescription, and your doctor must complete a detailed form called the Certificate of Medical Necessity (CMN).
  • You must order the scooter from a Medicare-approved durable medical equipment (DME) supplier, not from a retail store or online retailer.
  • Medicare pays 80% of the approved amount after your Part B deductible; the supplier bills Medicare directly if they are in-network.
  • Rental is an option if you need a scooter temporarily, and Medicare may cover rental costs under the same rules as purchase.

What Medicare requires before paying for a scooter

Medicare has strict rules about who can receive a scooter. Your doctor must document that you have a medical condition that limits your ability to walk. Specifically, Medicare requires that you cannot walk more than 150 feet without stopping to rest, or that walking would be unsafe because of a medical condition. Conditions that commonly may have access to include severe arthritis, heart disease, lung disease, neurological disorders, or recovery from surgery.

Your doctor must also confirm that you have tried a cane or walker and that these devices do not meet your needs. If you have never used a cane or walker, your doctor may need to document why these would not work for you. Medicare does not cover a scooter as a first choice; it is considered a last resort when other mobility aids have been ruled out.

The doctor visit that documents your need must happen within six months before your prescription. If your last visit was more than six months ago, you will need a new appointment. During this visit, your doctor completes the Certificate of Medical Necessity (CMN), which is a detailed form that explains why you need the scooter and confirms you meet Medicare's requirements.

How to order a scooter through Medicare

You cannot buy a scooter from a retail store or online retailer and then ask Medicare to reimburse you. You must order from a Medicare-approved durable medical equipment (DME) supplier. You can find approved suppliers in your area by visiting the Medicare website or calling 1-800-MEDICARE. Ask for suppliers that carry mobility scooters and confirm they accept Medicare assignment (meaning they bill Medicare directly).

Once you have chosen a supplier, give them your doctor's prescription and the completed CMN form. The supplier will verify your Medicare coverage and tell you what your out-of-pocket cost will be. They handle the billing to Medicare. If the supplier is in-network and accepts assignment, Medicare pays them directly and you pay only your 20% coinsurance after meeting your deductible.

The supplier may also ask for your prior authorization number from Medicare before ordering the scooter. Some suppliers request this themselves; others ask you to contact Medicare first. Ask the supplier what they need from you and what they will handle.

What scooters Medicare will and will not cover

Medicare covers standard three-wheel and four-wheel mobility scooters that are used indoors and outdoors on level ground. The scooter must be a model that Medicare recognizes as durable medical equipment. Scooters designed for off-road use, racing, or specialized sports are not covered.

Medicare also does not cover scooters that are primarily for convenience or comfort rather than medical necessity. If you want a scooter with extra features—such as a larger seat, upgraded suspension, or higher speed—Medicare covers only the basic model that meets your medical need. You can pay out of pocket for upgrades, but Medicare will not reimburse the extra cost.

Accessories such as baskets, lights, or rain covers are sometimes covered if they are medically necessary, but this is decided on a case-by-case basis. Ask your supplier whether specific accessories are covered before you purchase them.

Renting versus buying a scooter

Medicare covers both rental and purchase of a mobility scooter under the same medical necessity rules. Rental may be a good option if you need a scooter temporarily—for example, while recovering from surgery or a broken leg. Medicare typically covers rental for up to 13 months. After 13 months, if you still need the scooter, Medicare switches to covering purchase instead.

Rental payments count toward the purchase price if you later decide to buy. This means if you rent for several months and then purchase, the rental payments you made reduce what you owe for the scooter itself. Ask your DME supplier to explain how this works with your specific scooter and rental agreement.

Some people choose to rent first to make sure a scooter works for them before committing to a purchase. This can be a practical approach if you are unsure whether you will use it long-term.

What to do if Medicare denies your scooter claim

If Medicare denies your claim, the DME supplier must send you a notice called an Explanation of Benefits (EOB) that explains why. Common reasons for denial include: your doctor did not complete the CMN form correctly, your visit with the doctor was more than six months before the prescription, or Medicare determined the scooter was not medically necessary based on your medical record.

You have the right to appeal a denial. You can ask your doctor to provide additional documentation about your medical condition and why you need the scooter. You can also ask the DME supplier to resubmit the claim with more detailed information. If you disagree with Medicare's decision, you can file a formal appeal. The appeal process has several levels, and you can request a hearing if needed.

Contact 1-800-MEDICARE or your DME supplier to understand the specific reason for the denial and what steps to take next. Your doctor's office can also help you gather the information needed for an appeal.

Medicare Advantage and Medigap coverage for scooters

If you have a Medicare Advantage plan (Part C), your coverage for scooters may differ from Original Medicare. Some Medicare Advantage plans cover scooters under the same rules as Original Medicare, while others have different requirements or may not cover them at all. Contact your Medicare Advantage plan directly to ask about their scooter coverage before you see your doctor.

If you have a Medigap plan, it typically covers the 20% coinsurance that Original Medicare does not pay. This means you may have little or no out-of-pocket cost for the scooter. Check your Medigap plan documents or call your plan to confirm your coverage.

Questions to ask your doctor

Before your appointment, write down the mobility problems you are having and how they affect your daily life. During the visit, ask your doctor these questions:

  • Do you think a mobility scooter would help me with my medical condition?
  • Have I tried a cane or walker, and if not, why would they not work for me?
  • Will you complete the Certificate of Medical Necessity form for Medicare?
  • What specific type and model of scooter do you recommend?
  • How long do you expect I will need to use the scooter?

Frequently Asked Questions

Can I buy a scooter myself and then ask Medicare to pay me back?

No. Medicare only pays when you order through a Medicare-approved DME supplier. If you buy a scooter on your own, Medicare will not reimburse you. Always get your doctor's prescription and order through an approved supplier first.

What if my doctor says I need a scooter but I have not tried a cane or walker?

Your doctor can document why a cane or walker would not work for your specific condition. For example, if you have severe arthritis in both hands, a cane may not be safe. Your doctor explains this in the CMN form, and Medicare reviews it. You do not necessarily have to try and fail with a cane first.

How long does it take Medicare to approve a scooter?

Approval typically takes one to two weeks after the DME supplier submits your paperwork to Medicare. The supplier can tell you the expected timeline. If Medicare needs more information from your doctor, approval may take longer.

Will I have to pay anything out of pocket?

Yes. You pay 20% of the Medicare-approved amount after you meet your Part B deductible. The exact cost depends on the scooter model and your deductible status. Your DME supplier can give you an estimate before you order.

Can Medicare cover a scooter if I use it mainly indoors?

Yes. Medicare covers scooters used indoors, outdoors, or both. The key is that your doctor documents a medical need for mobility information, not where you plan to use it.