Medicare covers wheelchairs and other mobility devices, but only through Part B, and only when a doctor says you need one for a medical reason

Medicare will pay for a wheelchair if your doctor prescribes it as medically necessary — meaning you cannot walk safely without one, or walking causes you pain or injury. The coverage is not automatic. You need a written order from your doctor, and Medicare pays a portion of the cost while you typically pay the rest as your share of the bill.

The device must come from a Medicare-approved supplier, and Medicare covers the rental or purchase of standard manual wheelchairs and some motorized models. The amount Medicare pays depends on the type of device and whether you choose to rent or buy. Your out-of-pocket cost varies based on your Part B deductible and whether you have supplemental coverage.

Key Takeaways

  • Your doctor must write an order stating that a wheelchair is medically necessary before Medicare will consider paying for it.
  • Medicare Part B covers wheelchairs obtained from Medicare-approved suppliers, and you pay 20 percent of the approved amount after you meet your Part B deductible.
  • Standard manual wheelchairs are covered more readily than motorized models, which require additional documentation about your ability to operate them.
  • You can rent or buy a wheelchair through a Medicare supplier, and the rental-versus-purchase decision affects your total out-of-pocket cost.

How to get your doctor's order for a wheelchair

Start by talking to your primary care doctor or the specialist treating your mobility issue — your orthopedist, neurologist, or physical therapist. Tell them specifically why you need a wheelchair: you cannot walk without pain, you fall frequently, you tire quickly, or another medical reason. The doctor will examine you and decide whether a wheelchair is medically necessary.

If your doctor agrees, they will write a written order (sometimes called a prescription) that states what type of wheelchair you need — manual, motorized, or a specific model. This order is what Medicare uses to determine whether to pay. Without this order, Medicare will not cover the cost. Keep a copy for your records and give one to your wheelchair supplier.

What types of wheelchairs Medicare covers

Medicare covers standard manual wheelchairs as a matter of routine when a doctor prescribes them. These are the most common type and usually the least expensive. Medicare also covers motorized wheelchairs (called power wheelchairs or scooters), but the rules are stricter. Your doctor must document that you cannot operate a manual wheelchair safely — for example, because of weakness, arthritis, or a neurological condition — and that you can safely operate a power wheelchair.

Specialized wheelchairs, such as those designed for sports, all-terrain use, or custom seating, are rarely covered. Medicare also does not cover wheelchair accessories like cushions, trays, or bags unless they are considered medically necessary and your doctor orders them separately. Ask your supplier which specific model your doctor's order allows, because Medicare only pays for the model listed.

Renting versus buying through Medicare

You can rent or purchase a wheelchair through a Medicare-approved supplier. If you rent, Medicare typically pays for up to 13 months of rental. After 13 months, the wheelchair becomes yours to keep, and Medicare stops paying the rental fee. If you buy outright, Medicare pays a one-time amount toward the purchase price.

The financial choice depends on how long you expect to use the wheelchair. If you may need it for only a few months, renting is usually cheaper. If you will need it for years, buying often costs less overall because the rental payments stop after 13 months. Ask your supplier to show you the cost of both options before you decide. Your out-of-pocket cost is 20 percent of Medicare's approved amount, after you have met your Part B deductible for the year.

Finding a Medicare-approved wheelchair supplier

Not every medical supply store is a Medicare-approved supplier. You can search for one on the Medicare website by visiting the Supplier Directory at dmepos.cms.gov (DMEPOS stands for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies). Enter your ZIP code and select "Wheelchairs" to see which suppliers near you accept Medicare.

You can also ask your doctor's office for a referral to a supplier they work with regularly. Once you have chosen a supplier, give them your doctor's order and your Medicare card. The supplier will handle the paperwork with Medicare and bill you for your 20 percent share. Always confirm with the supplier that they are Medicare-approved before you place an order, because using a non-approved supplier means Medicare will not pay anything.

What you will pay out of pocket

Your cost depends on three things: whether you have met your Part B deductible for the year, the Medicare-approved amount for the wheelchair, and whether you have supplemental insurance. After you meet your Part B deductible (which varies by year), Medicare pays 80 percent of the approved amount and you pay 20 percent.

For example, if the Medicare-approved amount for a manual wheelchair is $1,000 and you have already met your deductible, Medicare pays $800 and you pay $200. If you have not met your deductible, you pay the full deductible amount first, then 20 percent of the remaining cost. If you have a Medigap or Medicare Advantage plan, your supplemental coverage may pay some or all of your 20 percent share, so check your plan documents or call your plan to ask.

What happens if Medicare denies your claim

Sometimes Medicare denies a wheelchair claim because the doctor's order was incomplete, the supplier was not approved, or Medicare determined the wheelchair was not medically necessary. If this happens, you will receive a notice called a Medicare Summary Notice (MSN) or an Explanation of Benefits (EOB) that explains why.

You have the right to ask Medicare to reconsider. This process is called an appeal. You must file your appeal within 120 days of the denial notice. Contact your supplier or your doctor's office to help you gather the information Medicare needs — usually additional medical records or a more detailed explanation from your doctor about why the wheelchair is necessary. If you disagree with the appeal decision, you can request a hearing before a Medicare official.

Frequently Asked Questions

Does Medicare cover wheelchair cushions or other accessories?

Medicare covers wheelchair accessories only if your doctor orders them separately as medically necessary. A pressure-relief cushion, for example, may be covered if you have a pressure wound or are at high risk for one. Ask your doctor whether any accessories you need can be ordered and billed to Medicare, or whether you will need to pay out of pocket.

Will Medicare pay for a motorized scooter instead of a wheelchair?

Yes, if your doctor prescribes it and documents that you cannot safely use a manual wheelchair. Motorized scooters are covered under the same rules as power wheelchairs. Your doctor must state in writing that you have the ability to operate the scooter safely and that a manual wheelchair is not sufficient for your medical needs.

Can I choose any wheelchair I want, or does it have to be a specific model?

Your doctor's order specifies the type of wheelchair Medicare will pay for. You can work with your supplier to choose a model within that category, but Medicare only pays for the model and features your doctor ordered. If you want a more expensive or specialized model, you can pay the difference out of pocket.

What if I need a wheelchair urgently and cannot wait for the approval process?

You can purchase or rent a wheelchair when ready from any supplier, but Medicare will only pay if you follow the process: get a doctor's order, use a Medicare-approved supplier, and submit the claim. If you buy from a non-approved supplier or without a doctor's order, you will pay the full cost yourself. It is worth waiting a few days to may support Medicare will cover it.

Does Medicare Part D or Part A cover wheelchairs?

No. Part D covers prescription drugs only. Part A covers hospital and skilled nursing facility stays, but not equipment you use at home. Wheelchair coverage is only through Part B, which covers outpatient services and durable medical equipment.