Medicare covers a new wheelchair once every five years, with some exceptions for damage or major changes in your condition

Medicare Part B pays for a wheelchair (called a "mobility device" in Medicare language) once in a five-year period. If your wheelchair is damaged beyond repair or your medical condition changes significantly, you may be able to get a replacement sooner. The wheelchair must be prescribed by a doctor, ordered through a Medicare-approved supplier, and deemed medically necessary for your mobility.

The five-year clock resets from the date Medicare paid for your last wheelchair, not from when you received it. If you need a wheelchair before five years have passed, you will need to show Medicare that your old one is no longer usable or that your condition has changed enough to require a different type of device.

Key Takeaways

  • Medicare covers one wheelchair per five-year period under Part B, with the cost split between Medicare (80%) and you (20% after your deductible).
  • Your doctor must write a prescription and document that the wheelchair is medically necessary for your mobility at home or in the community.
  • You must order from a Medicare-approved durable medical equipment (DME) supplier, not directly from a manufacturer or non-approved vendor.
  • You can request an earlier replacement if your wheelchair is damaged beyond repair or your medical condition has changed significantly enough to require a different device type.
  • Medicare does not cover wheelchairs for temporary use (such as after surgery) or for comfort rather than medical necessity.

What Medicare considers medically necessary for a wheelchair

Medicare will not pay for a wheelchair just because you want one or because it would be convenient. Your doctor must document that you cannot walk safely or far enough to meet your daily needs, even with other aids like a cane or walker. The wheelchair must be something your doctor prescribes as part of your treatment plan, the same way they would prescribe medication.

Common reasons Medicare approves wheelchairs include severe arthritis that limits walking, Parkinson's disease, stroke recovery with lasting mobility loss, spinal cord injury, and advanced heart or lung disease that makes walking exhausting. Your doctor will need to explain in writing why a wheelchair is necessary and why other mobility aids would not work for you.

Medicare also looks at whether you can use the wheelchair safely. If you have severe cognitive decline or balance problems that make wheelchair use dangerous, Medicare may deny the claim. The supplier and your doctor will work together to make sure the wheelchair type matches your actual needs.

How to order a wheelchair through Medicare

Start by talking to your doctor about whether you need a wheelchair. Your doctor will write a prescription that includes the type of wheelchair (manual, motorized, or specialized), any custom features, and the medical reason. Do not order a wheelchair on your own — Medicare will not pay for it if you do.

Once you have the prescription, contact a Medicare-approved DME supplier in your area. You can find approved suppliers by calling Medicare at 1-800-MEDICARE or by searching the Medicare supplier directory online. The supplier will verify that Medicare will cover the cost, check your deductible status, and explain what you will owe out of pocket.

Medicare pays the supplier 80% of the approved amount after you meet your Part B deductible ($240 in 2024, though this amount changes yearly). You pay the remaining 20%. Some suppliers offer payment plans if the out-of-pocket cost is high. The supplier handles all paperwork with Medicare — you do not submit claims yourself.

When you can get a replacement before five years

If your wheelchair breaks and cannot be repaired, you may be able to get a replacement even if less than five years have passed. You will need documentation from the supplier showing that repair is not possible or would cost more than a new wheelchair. Your doctor does not need to write a new prescription for this type of replacement.

If your medical condition changes significantly — for example, you develop a new condition that requires a motorized wheelchair instead of a manual one, or you need a specialized wheelchair for a spinal cord injury — you may may have access to for an earlier replacement. Your doctor must document the change in your condition and explain why your current wheelchair no longer meets your needs. Medicare will review this documentation before approving payment.

Wear and tear from normal use does not count as a reason for early replacement. Medicare expects wheelchairs to last five years with proper care and maintenance. If your wheelchair is straightforward worn out but still functional, you will need to wait until the five-year period ends.

What you pay out of pocket

Your costs depend on your Medicare coverage and the wheelchair type. If you have not met your Part B deductible for the year, you pay the full deductible amount first (usually $240). After that, Medicare pays 80% and you pay 20% of the Medicare-approved amount.

A basic manual wheelchair typically costs between $1,000 and $3,000 in approved charges, meaning you would pay roughly $200 to $600 out of pocket. A motorized wheelchair (called a power wheelchair) can have approved charges of $5,000 to $10,000 or more, so your 20% share could be $1,000 to $2,000. Specialized wheelchairs for specific conditions cost more.

If you have a Medigap or Medicare Advantage plan, your out-of-pocket costs may be lower. Medigap plans often cover the 20% coinsurance. Medicare Advantage plans vary — some cover durable medical equipment the same way, others have different rules. Check your plan documents or call your plan to find out what you will owe before you order.

Types of wheelchairs Medicare covers

Medicare covers manual wheelchairs (which you push yourself), motorized wheelchairs (also called power wheelchairs), and scooters (three- or four-wheeled motorized devices). The type your doctor prescribes depends on your strength, balance, and ability to propel a manual chair.

Medicare also covers specialized wheelchairs for specific needs, such as tilt-in-space wheelchairs for people who cannot shift their weight, reclining wheelchairs for those who need to lie back, and lightweight wheelchairs for people who need to transport them frequently. Your doctor and the DME supplier will discuss which type fits your condition and lifestyle.

Medicare does not cover wheelchairs that are primarily for comfort or convenience, such as beach wheelchairs or all-terrain wheelchairs. It also does not cover wheelchairs for temporary use after surgery — those are considered short-term medical equipment, which may be covered under different rules.

What happens if Medicare denies your claim

If Medicare denies your wheelchair claim, the supplier will send you a notice explaining the reason. Common reasons for denial include: your doctor did not document medical necessity clearly enough, the wheelchair type does not match your condition, you already received a wheelchair within the past five years, or the supplier was not Medicare-approved.

You have the right to appeal a denial. The appeal process has several levels: first, you can ask the supplier to resubmit the claim with more information from your doctor. If that does not work, you can file a formal appeal with Medicare. The supplier can help you with this process, or you can contact your State Health Insurance information Program (SHIP) for free help understanding your appeal options.

If you need a wheelchair urgently and your claim is being reviewed, ask your doctor whether a temporary rental is possible while the appeal is pending. Some suppliers rent wheelchairs short-term, though Medicare will not pay for rentals.

Frequently Asked Questions

Can I buy a 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 the wheelchair would have been covered. Always get your doctor's prescription and work with an approved supplier before ordering.

What if I need a wheelchair but my doctor says I don't?

Medicare requires a doctor's prescription. If your doctor does not think a wheelchair is medically necessary, you can ask for a second opinion from another doctor. If the second doctor agrees a wheelchair is necessary, they can write a prescription and submit it to Medicare. You cannot override your doctor's judgment on your own.

Does Medicare cover wheelchair repairs or maintenance?

Medicare does not cover routine repairs, maintenance, or replacement parts like tires or cushions. You are responsible for keeping your wheelchair in working order. If your wheelchair breaks and cannot be repaired, you may may have access to for a replacement before five years if the damage is severe enough.

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

Yes, if your doctor prescribes a motorized wheelchair as medically necessary. You do not have to try a manual wheelchair first. Your doctor will consider your strength, balance, and ability to use different types of devices when deciding what to prescribe.

What if my wheelchair is stolen or lost?

Medicare considers theft or loss the same as normal wear — you will need to wait until five years have passed to get a replacement covered by Medicare. Some homeowners or renters insurance policies cover stolen medical equipment, so check your insurance. You can also ask your DME supplier about purchasing a replacement out of pocket or renting a temporary wheelchair.